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Underlying Factors of Chronic Fatigue – Dr. Jill Interviews Dr. Nafysa Parpia

Dr. Jill interviews Dr. Nafysa Parpia on underlying factors causing chronic fatigue and fibromyalgia.

They discuss what goes wrong with the body, how the cell danger response can become chronically activated, and some tips on treatments and testing that is useful in these patients.

Key Takeaways

Pre-tox (before detoxification)

  • Mast Cell Activation Syndrome (MCAS) often needs to be treated first to allow patients to tolerate other treatments.
  • Peptide therapies can be used to calm down the immune system.
  • Correcting sleep issues is needed before detoxification can start. Herbs, supplements, peptides, and certain antihistamines can be used.
  • Constipation needs to be addressed.
  • Any issues with the kidneys need to be looked at.
  • Herbs may be used as supportive therapies.

Detoxification

  • Detoxification needs to happen prior to and concurrent with treating infections. If the toxic load is high detox will cause negative reactions or “herxes.”
  • Each person has their own individual picture of factors causing symptoms, and will respond differently to treatment than other patients. Genetics are a factor there.
  • Treatment needs to be individually designed in response to that picture.
  • Arsenic and aluminum are being seen more, possibly due to the wildfires.
  • Medication is often required for the patient population seen at GMA.
  • Things patients can do themselves: coffee enemas for the liver, saunas or other means of sweating, dry brushing, castor oil packs, oil pulling, avoid buying foods and personal care products, home care products, etc. that contain chemical and toxins, eat organic.

Causes Behind Chronic Fatigue and Fibromyalgia

  • Pathogens are often involved: often parasites, viruses, tick-borne illnesses, mold, dental occult infections, sinus infections (fungal and MARCons).
  • With infections, you not only have to treat the infection but also restore the system.
  • Heavy metals
  • Infections and toxins hijack the system.
  • Hormone imbalances, especially sex hormones and thyroid.
  • GI imbalances and infections.

The Cell Danger Response

  • A monitoring system in the cell, modulated by the mitochondria, that looks for danger from pathogens, toxins, nutrient issues, emotional or physical stress, or other problems that can impact cell health.
  • In response to signals interpreted as dangerous, the cell sends out signals intended to create changes that protect the cell.
  • This response is happening all the time as the immune system watches for invaders. The problem is when the danger signal does not turn off, and the cell gets stuck in a defensive state.
  • The system gets stuck in this repeating loop of incomplete recovery and re-injury, and they’re unable to fully heal.
  • The CDR has three phases.
  • When CDR begins in enough cells you start to get symptoms like fatigue, brain fog, body aches and pains.
  • Part One involves the innate immune system. The neutrophils, the macrophages, natural killer cells, monocytes, the mast cells.
  • In Part One the mitochondria produces less ATP, exports the ATP outside the cell walls, and begins to depend on glucose for energy in anerobic respiration.
  • If someone gets stuck in Part One, you can see HPA axis issues, allergies, asthma, chronic infections.
  • Part Two is when we start to rebuild tissue damage through cell proliferation.
  • Mitochondria begin producing more ATP.
  • Someone stuck in Part Two may show proliferative disorders, cancers, hypertension, different heart diseases.
  • In Part Three the body is restoring intercellular communication.
  • Hormones and neurotransmitters are important in Part Three.
  • When stuck, we’re going to see illnesses like Chronic Fatigue Syndrome and fibromyalgia, autism spectrum disorder, PTSD, anxiety, depression.

Restoration

  • Chronic illness is traumatic
  • Regenerative treatments help restore balance

Transcript

This has been edited slightly for clarity and ease of reading.

Jill Carnahan (JC): Hello everybody! You’re here this afternoon with us and Dr. Nafysa, and I am so excited today about today’s topic.  I know a lot of you struggle with chronic fatigue or fibromyalgia. We’re going to do a really deep dive into some of the mechanisms behind that. You’re going to find some really fascinating information from Dr. Nafysa today that her practice, Gordon Medical Associates deals with and was actually instrumental in some of the research behind.  

So, stay tuned for that! Before we start, and before I give her a formal introduction, I want to just tell you a little bit of housekeeping. If you don’t already know, you can find all of these videos on my YouTube channel. Just go to YouTube and find my name, Jill Carnahan, and you can find all the 50 plus interviews there for free. I’d love if you subscribe or leave feedback there, or share those videos if you find them helpful. You can also re-watch them here on Facebook and on the podcast, so just all things medical here. If you do want information about blogs, information about Lyme disease, co-infections, fibromyalgia, chronic fatigue, other topics, you can find that on my website at jillcarnahan.com, and if we do mention any products or services, you can find those at drjillhealth.com.

So, Dr. Nafysa, I would love to formally introduce you, and I’m so glad you’re here today.  Dr Parpia has spent the last decade treating patients with complex chronic illness from all over the United States and the world. Her specialization is patients with tick-borne illness, environmentally acquired illness, mold and mycotoxin illness, autoimmunity, fibromyalgia, and chronic fatigue. Sounds real familiar! External factors to the body, such as environmental toxic burden, pathogens, diet, and lifestyle affect the balance of internal factors (and we’ll talk a little bit about that today); over or under expression of immunity, infection susceptibility, epigenetic expression, and cellular and biochemical function, mood and the microbiome.

All of these things are some of what we’re going to talk about that affect our mitochondria, which expresses fatigue, and some of these other things. Each of these aspects is different for every patient we see. Investigating to discover and remove the underlying cause while providing symptom relief, she uses cutting edge lab testing and deep intuition applied to the full range of scientific data to unravel the mystery of each patient. She then creates a carefully crafted treatment plan, highly personalized and healing.

She uses a synergistic blend of regenerative medicine, oral and IV micronutrient therapies, peptides, botanical medicine, pharmaceuticals, injection therapies, functional nutrition, and lifestyle counseling. She sees patients at Gordon Medical in the San Francisco bay area, and previously worked in Dr Klinghart’s clinic. She’s also, as I am, on the ISEAI (International Society of Environmentally Acquired Illness) board, and is scientific medical advisor for the Neurohacker Collective.

Absolute honor and delight to have you, Dr Nafysa! Thank you so much for joining me today.

Nafysa Parpia (NP): Thank you, Dr. Jill for having me. Such an honor to be here.

JC: Yes. So, we met through the ISEAI board, but I know this about the work you’ve done and it’s just, like I said, it’s an honor. It’s so parallel when I read your bio, you know, we’re all doing our things in our corners of the world trying to solve the mysteries of these chronic illnesses.

Before we dive into chronic fatigue and fibromyalgia, I’d love to hear just a little bit, and I know our listeners would, about your story and, kind of how you got into medicine and healing. Tell us just a little bit about your journey into this field.

NP: I always knew that I wanted to help people in their healing. I began as a yoga instructor, and the more I taught yoga, the more I realized I wanted to go deeper with people, particularly in illness and in health, and restoring illness into health. And so, I went to Bastyr and I studied naturopathic medicine there.

It wasn’t until I was in the offices of Dr. Dietrich Klinghart, when I graduated, and I saw people who were very, very, very sick, that was when my heart just went out to these patients. I could see that they were suffering, you know, but they weren’t treated at other clinics, before going to his clinic, with very much respect. They were told this is all in their head, or they’re just aging, and there was minimal treatment or minimal diagnosis offered to them. I could just feel the depth of their illness, and it was painful to see the judgments that were put upon them. So, I wanted to help, in helping create treatment and protocols and really dive deep with these people and help them out of the suffering that they were having a hard time coming out of. Yeah, gosh, I love that, because most of us who go into medicine in some form, it’s this healer within us that really does want to just help and understand.

And I think especially those of us who end up with environmental toxicity, mold, pathogens, chronic illness. No one in their right mind would choose this unless they were a healer, right?

JC: Exactly!  It is definitely the hardest, most complex form of medicine. I’m sure you agree.  I love it! I know you do too. Like, I love the complexity.  I always say the more complex the better. But it’s really, really difficult sometimes and these are not, these are the cases that the most conventional doctors don’t want to see, sadly, so it’s good that you and I, you know, are welcoming them to our practice. So, you’ve had such a great experience with some amazing medical partners. You were with Dr. Klinghart originally. Was that right after you graduated?

NP: Yeah, right after I graduated.

JC: Excellent, fantastic! You probably got a little bit of good information on Lyme and co-infections and all of that there, and he’s so good at some of the environmental toxicity and the stuff that’s on the cutting edge. I always feel like the Europeans are way ahead of us, and because he’s originally from Europe I love his perspective. He’s not jaded like many, right?

NP: Exactly! So, it was really wonderful. That’s where I first learned, right after school, really how to work with this population, about the tick-borne illnesses and mold and detoxification therapies. And from there I really made it my own.

JC: Yeah! Was there anything in particular with that experience that you learned as far as how to approach a chronic infection or…  Well, first of all we’re talking about chronic fatigue, fibromyalgia. So, say you had a patient with fibromyalgia, chronic fatigue, from your early days was there anything that sticks in your mind about lessons that you learned about how to approach them?

NP: Absolutely! So, the first was to detoxify them first. To find out what the toxic burden is. So, testing through different labs, looking at different heavy metals or different chemicals, glyphosate, different pesticides and understanding what that burden is.

Because if we detoxify them first, then then we can get the immune system to be more modified. We can we can get it to be more able to handle the killing of infections.

JC: What a great pearl! And for those of you listening, you’ve probably been to doctors who are like, “Oh, let’s start these antibiotics.” But what you’re saying, which I’ve seen that as well, it’s like the body, if its toxic load, if its bucket is full, and that’s usually the ones that are coming to see us because some of that pain and fibromyalgia types of stuff. Again, we’ll go deep into why that happens and some of the reasons behind it is from the toxic burden in the tissues, right? So, if you take a person like that, they have infections that need treating but you throw these even herbal antibiotics, but for sure medications, it’s too much for their system to handle, isn’t it?

NP: Right. They’ll actually backfire. A lot of times they’ve got this hyperactivity in the immune system. On one hand they’ve got a hyperactive immune system and on another hand of the immune system it’s it it’s too weak to even mount an appropriate immune response. So many times, if we try to treat them with the antibiotics, herbal or pharmaceutical, first they’ll be sensitive to those treatments. So, we have to decrease the toxic load and get the mast cells in order first, and then like…

JC: I love that order, because it’s so important, I’ve noticed that with my own practice as well, where again, if there’s infection and toxins and mast cell activation, which is common, and chronic fatigue and fibromyalgia, you really can’t go to treatment until you start with getting that mast cell calmed down and the detoxification at least under control.

What are some of the things when they first come in like that, would you, what kind of testing panels would you do for the initial assessment?

NP: So, I like to do the Great Plains panel where I’m going to look at their glyphosate, mycotoxins. Most of my patients do have a high mycotoxin load and also on their tox panel while I’m looking at a lot of chemicals. I’ll also do the Doctor’s Data heavy metal provocation, but I’m also going to look at metals unprovoked first. Just from Labcorp, just urinate in a cup or to have their blood taken at Labcorp looking for the ones that Labcorp will look at, like mercury, lead, aluminum, arsenic. By the way, I’m seeing a lot of arsenic.

JC: Yes!

NP: In people’s blood, and I think that’s from the fires. It’s not something I saw in previous years. It’s all of a sudden, this year, whoa lots of arsenic!

JC: I bet you’re right. I suspect with the fires there’s definitely a lot of metals that were released and I’m seeing more and more aluminum in all of my patients.

NP: Yes! Which I didn’t see.

JC: And I’m like where else is it coming from because we know like vaccinations over time can be a source, aluminum cookware, um, what are some other sources of aluminum that you think of when you see aluminum? Is there anything else that you think of?

NP: You know, I recently, I had a drummer. I have a drummer in my practice and he drummed bare foot and there was aluminum on the pedal.

JC: Wow!

NP: And aluminum was through the roof. I just measured it so…

JC: Wow, that’s so that’s so fascinating! Isn’t it funny when you find one of those, where you’re like, oh I think this is from this?  And arsenic too. I think it’s more in the rain water, but probably from the fires, and then the rain and the soils and yeah, so, wow! Very good! One thing we kind of glossed over, we talked about how you got into this medicine, but is there anything else that interests you about this population? I mean, we talked a little bit about the helping, the healer within you, but because again this is a population that is very complex. But you must love to solve problems. Is that one of your…

NP: I love to solve problems. I love to solve human problems.

JC: Yes! Yeah, exactly, right?

NP: I’m not an engineer, you know, but the human problems. But it is very much a mystery. It’s very much a puzzle and each person is their own mystery. So, while I run the same labs for everybody, I’m going to find different pieces, and one person will react very differently than another to treatment, or from the same exposure.  A lot of that has to do with the genes.

So, speaking of labs, I like to use the IntellxxDNA.  I found that they really looked at how the snips will interact with one another, as opposed to just here’s a snip, or there’s a snip. They’ll look at them together, and they really culled the research to look at what diseases are related to which genes that are acting in symphony with one another.  So, it’s an expensive test…

JC: This is great! I just started doing this. I have a couple patients pending. I did it on myself and it’s pending, and I’ve got Sharon coming on, so stay tuned for the show because I’m so excited because we’ll have her talk about that. She’s the expert, the medical director of IntellxxDNA. Yeah, I love that you’re using that, because I’ve been, so many genetic tests out there aren’t there yet.

NP: Yeah, I found that this one is the most informative.

JC: I agree! So, say you have someone, and again, we’re going to get to fibromyalgia, chronic fatigue in a moment, and the Cell Danger Response, which I do want you to talk about. But before we go there, say you do have someone with arsenic or metals, or say they have a little bit of mast cell activation, they have chronic pain and chronic infection and toxic burden and all these things. If you do find metals are you going to do that early on, detoxification, are you going to do maybe some treatment? Where would you order that in in your treatment plan?

NP: I think it depends on the person, but most of my patients I have to treat mast cell activation syndrome first. Usually, they come to me with that. They don’t even know they have it, so I just want to calm down the immune system. That’s the hyperactivity that I want to calm down.

I’ll use peptide therapies very often with that. I like to use thymus and Beta-4 to help calm down the immune system. I’ll use BPC-157 as well to help with decreasing inflammation. I’ll give them sleep peptides. Often, they need to sleep before they’re even ready to detox. Sometimes they’re constipated, so I need to deal with the constipation before they’re ready to detox, or else they’ll just be a backlog of toxicants that aren’t exiting the system. Sometimes they have issues with their kidneys so we have to work with that.  

Often with these patients I’m calming down their immune system while I’m working with other systems that aren’t quite ready for detox.  I’m doing like a pre-tox, I’m giving herbs to support, right, and then I’ll re-test some labs. See where they’re at. And also see where they’re at with the way they’re feeling. And then we’ll begin chelation therapy.

 JC: That’s tremendous and I always admire some of my best learnings are from my naturopathic friends because I feel like you guys have such a great training in some of those detox, what’s the name of it from naturopathic medicine of the detox pathways?

NP: The munterries?

JC: Yeah, I like that term because I’ve learned that over time, but traditional allopathic medicine, we’re not taught about this. Which is why most doctors, unless they go get extra education, they don’t even know. I feel like you guys have a lot to teach us in this way. Tremendous! What other things would you do? Some of the homeopathic remedies or drainage remedies or things? What about non-herbal, non-homeopathics, maybe epsom salt baths or alkaline water? Do you have any sort of just environmental or lifestyle things that are good for detox that you like for most of your patients?

NP: Yeah, most of them actually do well with coffee enemas, as strange as that sounds. Actually, it helps their liver to continue detoxifying. Saunas I think are really important, or at least getting the sweat going, because the skin is the largest organ of detoxification. And of course, making sure that they’re not using products that have chemicals and toxins in them, and they’re eating organic as much as they possibly can.

JC: Fantastic! Yeah, and do you do castor oil packs or a dry brush or some of those?

 NP: Yes! Yes, castor oil packs, dry brushing, oil pulling. Yeah, we use a combination of very classic naturopathic techniques along with this patient population, I have to use a lot of medications.

JC: Yes. Definitely, especially with MCAS you really sometimes need to layer four, five, six, things.

NP: Yeah! It turns out, when I went to naturopathic school these were the treatments that were taught to us, and they’re wonderful for the population that’s not extremely sick, and for the people that are extremely sick, they’re excellent, supportive, and I consider them foundational, but then I have to go into stronger…

JC: Right, right. I love it though, because we’re pulling from both worlds, because I like to learn from the homeopathic, naturopathic world, but we still need medications of course, on both ends, so great. So, we talked about your interest, and so let’s go, let’s dive into what’s behind these illnesses, because there’s so many. I’ll just let you talk a little bit about what’s behind, and then after that we can go into the Cell Danger (Response).  I definitely want to talk about that. So, behind these illnesses, what was so great is the bio that I read for you, you literally listed what’s behind these illnesses in your bio.  I love that, but talk a little bit about what those are, so someone who has fibromyalgia, chronic fatigue, who is listening, what might be some of the causes behind that?

NP: In classic fibromyalgia they say there’s no cause, right, and then you get them working and they’re supposed to be better. Most of my patients are not like that. If I give them Lyrica it’s not going to really help. Maybe a little bit for a couple weeks, and then nothing.  So usually, I’m looking for pathogens, often parasites, viruses, tick-borne illnesses, mold, dental occult infections.

JC: That’s very common, isn’t it?

NP: Right, sinus infections, which I think is overlooked a lot. I bet you’re thinking the same thing about the sinus. It’s so close to the brain, and I’m finding a lot of funguses or MARCons in people’s sinuses, and once I treat that their brain fog begins to resolve, because I think of the inflammatory cytokines, the bugs that are in the sinuses…

JC: I find this to be one of the biggest missing pieces of people who’ve been to mold treatment other places.  I’m like, did anyone treat your sinuses? Like, no! This is a really big deal.

NP: I totally agree!  I’ll treat the sinuses the same way I treat the gut, actually, by killing the infections, restoring the whole thing.

JC: What do you like, let’s pause there real quick, because what do you like to use? I mean I have some herbal favorites and some prescription favorites, but what are some of your preferred ways to treat the sinuses? Do you do irrigation, do you do sprays, do you compound, do you do herbs?

NP: I do compounding very often. I’m going to start with Argentyn silver. I found that if people do this, if they nebulize it, not just spray it, but they atomize it so it really goes up high, then I’ve seen that really reduce brain fog. If they do this, and this is a tall order, like four or five times a day for two weeks. It’s changed people’s lives, people who are not chronically ill but that have brain fog, that has changed their life just doing that.

JC: And just plain silver or with EDTA, or would you use both?

NP: I start with silver, and then I also have them do at night a nasal probiotic flush, and then also I’ll have them put coconut oil in their nostrils because it’s hard to kill infections in the sinuses when they’re dry. They’ll do that for two weeks, and then I’ll move into using Chelating PX, which is EDT to bust up the biofilm.  And then if they have a fungus, I might use amphotericin or BEG spray if there’s MARCons, so whatever antibiotic they need.  I’ll use that, we’ll be atomizing that.

JC:  that was tremendous and I love a couple things you mentioned. First of all, that you start with silver without EDTA, because I think sometimes that biofilm busting is way too much. They get headaches or they get really sick because all of a sudden, it’s a dumping of the dead material that’s being… I think of the biofilms, if you’re listening, as pond scum. It’s like this kind of gross covering that keeps everything hidden from the antibiotics or the silver. So you need to bust it up to clear it out, but if you bust it up too much too quickly the system gets overwhelmed and the mast cells get angry too, right?

NP: They sure do! I think of it as a gentle way in before I, in fact that’s the way how I’ll treat most people. We’ll start and I’ll start gently and ramp them up.

JC:  I’ll just remember this, and the other thing mentioned, the dryness, because most of us aren’t flying a lot nowadays, but it’s just flying in an airplane, it’s so dry! That’s why people tend to get more sick, or used to. Again, now things are just very different. Still toxic, because they spray all these chemicals, but the dryness of the air. And here I am in Colorado, which is really dry, that really makes a difference, the moisture.  I love that you recommended… now are you having people just put it just in their nostrils a little bit?

NP: Yeah, just have them take a Q-tip and just put it in.

JC: Instead of Vaseline, which is petroleum-based, right?

NP: Right, exactly.

JC: Oh, that’s a great pearl. So, we talked about nasal and then I interrupted. What else would be the underlying factors in the chronic fatigue and fibromyalgia?

NP: So definitely heavy metals, which we already talked about. I think of this, it’s a whole soup, so it’s not salad like where’s the tomato, here’s a piece of celery, it’s the whole thing together in one soup.

So, metals, usually there’s a high viral load, I’ll measure people’s nagalase. I love the Infectolabs test, by the way, because now we can use T cells to look at if the infection is active right now or no, as opposed to looking antibodies where we have to kind of guess, right?  I’ll use that test to see if there’s a high viral load. If there’s mold, I like to look at the mold IgG, at allergens as well as mycotoxins. So, I’ll look at that on Labcorp.

Basically, I’m hunting for different infections and different toxins because those are the two things that I think hijacked the system. Of course, I’m looking at their hormones, their sex hormone panel and their thyroid, because those are areas that are going to be affected, as well, causing fatigue.

JC: Excellent! So, pathogens, toxins, infections, and hormones and oh this is great!

NP:  And the gut, of course the gut.

JC: Yes, and you always do like stool and organic acids, or how do you like to assess the gut?

NP: Yeah, I like the GI Map Test. I find it to be the most sensitive so I look there, and most of my patients also have SIBO, which I generally like to treat first.

I like the Trio Smart Test because you’re looking at hydrogen sulfide SIBO, and no other test has done that before. So that that will give us a chance to find SIBO in ways we haven’t been able to before.

JC: Yes, now the key is, then what do we do with hydrogen SIBO? I’ve read a little bit about some of the pearls for treatment. But if you do find hydrogen sulfide is there any particular things you do differently with treatments or herbs?

NP: You know for sure I’m having them decrease sulfur in their diet. But I’m using the same treatment as I would for regular SIBO, which is the Xifaxan, Flagyl, the bismuth to bust up the biofilm, goldenseal to prevent yeast.

JC: Yes, oh fantastic! Sounds so similar and so important, because again that gut…

I love that you mentioned two things that I think are so critical, that you really can’t get past, and that’s sleep and constipation. So, if you have someone coming in that has insomnia or constipation, no matter what kind of protocol you put them on, if they’re not sleeping and they’re not pooping, you’re not gonna get very far, right?

NP: No, no, no exactly!

JC: What do you feel for sleep, because a lot of these patients have sleep issues, and it’s related to everything else we talked about. Any tips or tricks that you have for helping patients sleep?

NP:  I have an ayurvedic sleep tea which I really like. There’s cardamom in it. Cardamom helps people stay asleep. There’s ashwagandha and shatavari in it, that can help people. Now there’s some people who that doesn’t help, or you know the regular things, like valerian or GABA or L-theanine, that’s not helping them. I’ll go to peptides for them. I like Epitalon for sleep, or delta-inducing sleep peptide. Those really, really help people and it makes me not have to use, and I’d like to not use benzos for their sleep, right? I found that peptides can be a way around having to use benzos for those people who just can’t sleep no matter what herb I give them or no matter what sleep hygiene techniques we give.

JC: This could be tricky in the tick-borne infections. They complain to that too, and the activation of the immune system, so I find that sleep issues for some people is really hard to hack. But like you said, between peptides and herbs and then there was some, oh I was thinking antihistamines can be, like hydroxyzine and those can be really helpful.

NP:  Yeah, because often actually I give ketotifen for mast cell activation syndrome and it really helps them to fall asleep. There’s the odd person, I found in my practice, that makes them groggy in the morning. Not too often, but sometimes I can’t give them ketotifen.

JC: Great tips! So, let’s talk about this Cell Danger Response (CDR), because I know Gordon Medical center was where, you had told me right before we got on live, that you guys had actually done some of the research with Dr. Naviaux (Bob Naviaux, PhD). So, tell us first what is it, and then you can just dive in, I can ask some questions, but I definitely want to talk about this.

If you haven’t heard about the Cell Danger Response, this is groundbreaking!

NP: So, at Gordon Medical we provided the patients that Dr. Naviaux did research on. This was right before I joined Gordon Medical. Gordon Medical and Dr. Naviaux were involved in in the research together then, and wrote the paper on this, and it is groundbreaking.

Metabolic features of chronic fatigue syndrome: Robert K. Naviaux, Jane C. Naviaux, Kefeng Li, A. Taylor Bright, William A. Alaynick, Lin Wang, Asha Baxter, Neil Nathan, Wayne Anderson, Eric Gordon, Proceedings of the National Academy of Sciences Sep 2016, 113 (37) E5472-E5480; DOI: 10.1073/pnas.1607571113

So, the Cell Danger Response, it’s modulated by mitochondria, which is the energy producing part of the cell, and it’s also sensing when the cell’s not getting the nutrients it should be getting. So that means that the cell’s in danger. It’s signaling the immune system to take action. That there is danger. It can happen when there’s a virus in there, or a toxin that ties up nutrients, and the mitochondria will then send a signal to other cells. But that signal is that it starts to send ATP outside of the cell. So actually, around the cell membrane instead of inside the cell.

 The important thing to remember is that it’s not an on and off signal. There’s a little bit of the signaling every day to help your body pay attention to when there is an invader; a pathogen or a toxin or stress, whether that’s emotional or physical stress. So, it doesn’t have to be a disease. It’s really actually happening constantly as a normal defense mechanism, but when the signal persists, that’s when illness occurs. There’s a healing response that’s stuck in this loop and it just can’t stop. Mast cells are constantly activated, the immune system is constantly activated, so it’s like trying to understand, where do I cut that loop, how do I stop the cell danger response from happening?

Speaking of chronic fatigue, Dr. Naviaux, and Gordon Medical, the research occurred on Chronic Fatigue Syndrome, itself.

JC: Yeah, so yeah, associated. I mean he’s associated Cell Danger Response with Lyme disease, with autism, with chronic fatigue, yeah, so it’s been really wide. Like it’s one of the things that I know you and I, we can see it unifies a lot of these complex chronic illnesses that we see. Almost all of them, actually.

NP: Exactly! Yeah, they’re stuck in this repeating loop of incomplete recovery and re-injury, and they’re unable to fully heal.

JC: Talk a little about that, because there’s the Cell Danger Response, with phase one, two, and three, and each of those, if it gets stuck, there’s different sets of illnesses and things. You want to talk a little bit about some of those, and the differences between them?

NP: Sure! Part One involves the innate immune system. The neutrophils, the macrophages, natural killer cells, monocytes, the mast cells. These cells come out, the mast cells come to prime the immune system and then the other cells will come out to begin the killing, and may actually do the killing. But the infected cells, at this point they stop making normal amounts of ATP, and this is when they start to export the ATP to the cell membrane outside the cell. That’s the danger signal, usually signaling the rest of the body cells, “Hey there’s a danger here, there’s a toxin, there’s a bug that’s activating the innate immune system.”

So, we see, if it happens in a lot of cells, that’s when we start to see the sick behavior: fatigue, brain fog, body aches and pains. If it only happens a little bit, we’re just going to get a stuffy nose. But at this point they’re depending on glucose for energy instead of ATP, because the mitochondria are now browning out. So, it’s anaerobic respiration. They’re producing little energy, so we’ll see illnesses here. If we’re stuck here, we’ll see HPA axis issues, allergies, asthma, chronic infections which are often underneath chronic fatigue syndrome and the fibromyalgia that I see. So, it can be stuck here and in part two and part three which I’ll talk about in a minute.

So, it can be stuck in different parts and all different systems of the body.

Part Two is when we start to rebuild tissue damage, and that’s cell proliferation. The mitochondria start to go back to producing more ATP, but it’s still anaerobic. We’re not burning fat still.  We’re still burning energy from glucose, but there’s less of an inflammatory signal, so here it’s more proliferative disorders, cancers, hypertension, different heart diseases.

Then there’s Part Three, where we’re restoring intercellular communication. The cells learn how to function as a part of the whole, so a lot of hormones are important here. Neurotransmitters are important here. So here we’re going to see illnesses like Chronic Fatigue Syndrome and fibromyalgia, autism spectrum disorder, PTSD, anxiety, depression.

JC: I love it, because you really cover all of medicine like this. This is such an underlying cellular, like, we’re talking about at the cell level. One of the things that goes wrong, which is why when Dr. Naviaux really has presented his data, all of us were just like, wow! I remember two years ago, at ISEAI, when he presented, and you involved a little bit in the research. So maybe you knew some of the back story, but for me, and most of us, who hadn’t heard a lot of the research, it was literally jaw-dropping! Oh my goodness, this is amazing! Because it just puts everything together.

I’m gonna try to, I may not be exactly scientifically accurate. But for those of you who are listening, and you’re not super scientific, I’m going to try to explain in really simple terms what’s happening. You have a cell, and when the cell spills its contents, it’s broken, right? It like, spills out, then the contents get outside. That’s what’s triggering this, is outside the cell, it’s like, we call it like damage associated receptors. So basically, the damage to the cell, the contents of the cell got exploded or damaged or leaky, and then the outside is getting the signal that, oh, there’s cell contents outside the cell. This is not good.

I think of it real simplistically as you’ve spilled contents of a cell that was damaged, and outside the cell there was a signal. Because your body knows, it’s very smart, it’s like this should not be outside the cell. It should be inside the cell, and that’s the ATP.  The ATP as a cellular currency should be in the cell making energy for the cell. If it gets outside the cell this is the Cell Danger Response, and again, super simplified, probably not completely scientifically accurate. But for those of you listening to understand, it’s just the spilled contents. The cell’s broken, it’s damaged, and because this damage is telling the body, something is dreadfully wrong. You’ve got to mop up this mess you’ve spilled on the floor.

That’s kind of how I think of it in a simplistic way.

NP: Exactly that.

JC: So then, what do we do? Again, this is a cellular mechanism. There have been drugs studied to stop this that are highly effective. Unfortunately, they’re not available, right?

NP: Suramin.

So interesting. I think in medicine, we’re so good with A goes to B. Heart attack, broken bone, bullet wound, medicine knows what to do. But Dr. Naviaux calls what we’re talking about the black box of healing, the complex chronic illness. So, this is where it becomes highly personalized. When we look at the genes, we look for the toxins, we look, we’re looking for what is causing the most irritation in the system. For my patients, all of these things we just talked about, but usually it’s the immune system that’s the loudest first, and the mast cells. So back to that! Treating that.

JC: Back to where we started, which is starting with calming the mast cells, supporting immune system, clearing infections, treating heavy metals, toxicity, and then going down the road.

One question I just thought of as we’re talking, on fibromyalgia. I have heard some of the theories around having lactic acidosis, which is basically in the tissues you have a more acidic environment which can cause pain. Again, that can come from everything, it’s not a new theory, it’s nothing that’s different from what we’re already talking about. But have you found any sort of alkalinization therapies helpful? Like say, mineral water, Alka Seltzer Gold, some of those things, or even alkaline diets? Have you done anything along those lines?

NP: Absolutely! Alkaline diets I think really help, or intermittent fasting. For sure the detoxification is going to help.

JC: Yes, excellent! So, what else would we look at? Let’s go back to talk about chronic fatigue and fibromyalgia just slightly separately, because they are very similar in mechanism but we might treat them slightly differently.

Let’s start with fatigue, because fatigue is, most people who are sick they have some sort of fatigue.  They may not qualify for chronic fatigue (syndrome). Most of them do but even if they don’t, they’d usually have, and it usually is associated with brain fog. It’s so funny, because those of us in medicine, brain fog isn’t really defined, right, but every patient that we ever talk to, if we say brain fog, they know what we mean. So, we use that term a lot. How would you define brain fog, or what would people be complaining of when they come to you with that?

NP: Most of my patients have brain fog, actually. In tick-borne illness, I find the brain fog is actually more tied to pain than in people who have mostly just viral issues. But in both populations, the brain fog will manifest pretty similarly, or be experienced similarly. So, I just went into a room, and I forgot what I went there for. I went to the grocery store and I picked up peas, but I meant to get potatoes, or things like that. Or I just can’t think straight, a lot of them say I think I’m losing my mind. I actually find it’s more in the tick-borne illness patients that it’s that extreme, who say I think I’m going crazy.

But for women a lot of times, if they’re not sick, we can just fix the hormones. That’ll help them, right? But for these patients, if we fix the hormones, they’re still going to feel like they have brain fog. So that’s another sign that there’s something else going on.

JC: I love that, because I remember 15-20 years ago, when I started in functional medicine, I have a menopause patient or a patient with hypothyroid, and it’d be very simple, straightforward. We replace the hormones or balance their hormones or give them thyroid, and they feel better. And I don’t know when I’ve seen one of those kinds of patients lately, because there’s so many layers. If only it were that simple! Certainly, there are people who that’s all it needs is just a little tweaking, but I find that to be kind of a superficial level.

Not superficial, it’s very, very important, but it’s superficial enough that what we’re talking about here is usually way deeper causes. So, just doing that alone, unfortunately nowadays, at least for my practice, doesn’t usually 100% turn them around, right?

NP:  No, definitely not! I wish it would, and they wish it too. They say okay, now look, the labs say that my progesterone and my estrogen are back into balance, but I still feel the same. Still so terrible! Then I say, but you know that’s just a foundation for you? Now at least we have this foundation set, now we have to really get into the nitty-gritty of working on the immune system and working on bringing out the insults.

But what I also find is that once I can take, we can take the knife out, like the bugs, the toxins out, but  the symptoms still persist.

JC: It’s almost like a memory, right?  Even though you’ve cleaned up the terrain, the body still remembers and can kind of stay… What do you do with that? I’ve seen, we may even go into this, but I feel like emotional trauma, emotional health, some of these limbic system things are so critical. Tell me a little bit about your thoughts on that, and what would you do?

NP: I think that that’s really a big piece. That’s when a lot of times I might start to use regenerative medicine, actually exosomes or biological allografts. Those I found can really help. NAD IV can help a lot at that point as well. That’s looking at the biochemical piece, but you just talked about, and what I would consider such an important piece, which is the healing piece. These people have normally experienced a lot of trauma in their lives. That’s what I find.

Just like these illnesses have hijacked the different systems of their body, they’ve also had had people in their lives do what I would call hijacking their lives in some way. So much trauma, and so that that piece is really, really important.

I like to give them craniosacral therapy, and we have some amazing healers that we work with as well. So, I send them to the healers for that kind of work. Acupuncture…

JC:  I love that you’re mentioning that, because I feel the same and those aren’t my areas of expertise but I know people who do it. So whether it’s somatic based trauma therapies, whether there’s programs like DNRS program, Safe and Sound by Porges, or there’s a bunch of programs out there that are really helpful. Love craniosacral, love acupuncture, and naturopathy, we have some of the traditional emotional remedies, those types of things, with homeopathic remedies and things. Again, not my area of expertise, but those, all together can be really profound at that layer.

Because what happens with these illnesses, even if you’re healthy, you have a good family support system, the body subconsciously sees this mold or Lyme as a trauma, and so even if you’re super healthy and you weren’t abused as a child, it’s still a trauma. And then the medical system, I think, sadly, most of the time further traumatizes the patients.

NP: I agree, yeah, they really do. Because they haven’t been accepted.

JC: Yeah, they’ve been told they’re crazy, or go take this med for your mind, or it’s not… I mean, you might manifest as insomnia or bipolar or depression, anxiety, but these are not primarily psychological issues.

NP: Exactly, yeah, they’re secondary to the issue at hand, which is usually the infection or toxin.

JC: Yeah, I wonder nowadays if all mental illness isn’t really gut, microbiome, Cell Danger Response. I don’t know if there’s any pure psychological disorders anymore, because I can always find a root cause that’s actually physiological, right?

NP: Exactly, and then once it takes some time to turn these people around, but once they’re turned around, I see big shifts in their psychology…

JC: and moods and relationships, and it’s amazing, right? The whole dynamic to shift, so yeah, it’s amazing.

Well, let’s shift in our last couple minutes, because we’ve really covered a lot of ground. We talked a little about the limbic and some of these things, but what about just whether it’s social support, isolation, especially with COVID and the pandemic and all that we’ve experienced? What are some kind of mental health tips or social tips or things that you might encourage your patients to do, just to have a support system? Or anything in that realm that you would think about, or encourage them, or nature walks or things like that?

 NP: Yeah, there’s a lot of support groups out there. Sometimes I’ve heard patients tell me that, oh, that just really drags me into my diagnosis more. That’s just not what I want. And other people say, oh, I needed to meet more people just like myself. So, I think that everybody who’s interested should try to experience it and see if it’s for them or not. Some people it’s great, some people they don’t want that. Those I think are people who are more solitary people, and for them, for everybody, nature walks. I find grounding really helps. Just putting their feet in the sand, feeling the sunshine on them.

JC:  I love that! You’re in the bay area, did you say? You don’t always get sunshine.

NP: It can be cool down here.

JC: I love the earthing and grounding, and then, do you guys recommend pulsed electromagnetic fields (PEMF) in your clinic at all?

 NP: Yes and no. So, I’ve seen it blow up a lot of our patients. You know, they’re just not quite ready for it, so more towards the end of treatment I’ve seen it work really well.

JC: And with that NAD IV and exosomes and stuff, so the powerhouse is that. For me personally, at this level now, I love it, but I think it would have blown me out of the water five years ago. That makes sense.

Let’s see, I was thinking I wanted to go back to one other thing you mentioned, coffee enemas. I went to Switzerland for a detox, like the last two years, before, when we could travel. One thing that was there, that they had these coffee enema kits that were just so amazingly easy to use. It’s a Swiss mountain clinic. Used to be Paracelsus. So, we’ve actually imported those and I have them at the clinic. I want to be sure and let the listeners know if you want an easy way. Because I agree with you, the coffee enemas can be so profound, and you can get online kits and setups. Do you have those at your clinic that you sell or recommend at all?

NP: We don’t but, Ben Greenfield wrote a really good article, so I just send people that website. I’d love to hear about the winner.

JC: Perfect! I’ll include a link for the Coffee Enema Kit down here. I just want to mention it because it’s such a unique thing that we have at our clinic and we can ship to you anywhere in the U.S. We actually import them from Europe because they’re not made in the U.S. It’s a really simple setup with a bottle that’s bpa-free, and tubing and literally an instant, really, really clean low roasted green coffee with charcoal in it. It’s a German formula. It’s the cleanest thing I’ve ever found, and you just put it in the bottle, warm tap water, shake it up, and you’re done. So super easy to use. I’ll include a link in case anyone’s interested because it’s just one of those things where I found being in Switzerland, I’m like, we need this in the U.S. When I tried to figure out who had them, no one had them.

So last bit here. Where can people find you, where can people find more about you, are you accepting new patients? Tell us a little bit more about it.

NP: Yes, I’m accepting new patients. You can go to gordonmedical.com or just look up Gordon Medical Associates and all the information is over there. People come from all over the country particularly for the IV therapies actually. It used to be, when you were talking about socialization, it used to be that we had a big IV suite, and people would sit there and socialize. It would be their hangout time with people just like them, and they loved it! Now we can’t we can’t do it that way with COVID. People have their own private room, and we take all the precautions that we need to in order to make sure that it’s safe in there. But you won’t have company in there anymore…

JC:  But you still do it, and I have patients who have been there. So, again, nothing but good reviews and it’s just been neat to share a few patients once a while that have been back in here, so, I can attest to that. Just the great care. Now the other thing you mentioned. Before you go, you’re doing a summit. Tell us about what’s coming up with the summit.

NP: Yeah, so Dr. Gordon and I are going to be hosting a Mycotoxin and Chronic Illness Summit (July 12-18, 2021) through DrSummits. I’m very excited about it and hopefully you’ll be participating.

JC: I would love to!

NP: It’s going to be in June, okay, so we’re just starting right now. We’re hosting it with Dr. Christine Schaffner.  

JC: Oh wonderful! Because I love this stuff, so if you’re listening, I’ll be sure and if you go to the Facebook page, follow me on Instagram, just @drjillcarnahan, you will see the updates there. I’ll be sure and get information from you guys and share those links. So, if you’re interested in that summit, stay tuned I will have it on all my social media pages for everybody and we’ll share and I would love to be a part of it.

NP: Thank you! We’d love to have you!

JC: Awesome! Well, I can’t believe how quickly our hour goes! I think we’ve got some great information. Thank you so much for being here. We’ve got your website, I’ll be sure to include them. Thanks again for all the great information.

NP: Thank you so much for having me. Such an honor!

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