The Hidden Cause of Your Chronic Illness (It's Not What You Think) | Dr. Neil Nathan

Chronic illness rarely fits neatly into a single diagnosis. Symptoms can span multiple systems, leaving people profoundly unwell even when standard testing appears normal. I understand this experience from the inside out because I’ve lived it myself. Today, I sit down with Dr. Neil Nathan, a leading expert in complex chronic illness and author of Toxic, now in its second edition. We explore why these conditions are so often misunderstood and how identifying what is driving them can create a path toward recovery. We discuss: Why mold toxicity, Lyme disease, and long COVID can be so difficult to diagnose How to identify the root cause instead of chasing downstream symptoms What the Cell Danger Response is and why the body can remain stuck in survival mode Why some people suddenly become sensitive to foods, chemicals, medications, light, and sound Why the right treatment can make symptoms worse when introduced at the wrong time I’ve been sick enough to know how quickly chronic illness can narrow your world—and how discouraging it is when no one can explain why. But I’m also living proof that the body can recover. The answer is not always more treatment. Often, it begins with finding the root cause, respecting what the body can tolerate, and addressing each layer in the right order. View Show Notes From This Episode Sign up for Dr. Hyman’s Brainshaping Academy to learn how to nourish the biological systems that support your mental, emotional, and cognitive health https://drhyman.com/products/brainshaping?utm_source=dr_hyman_show&utm_medium=newsletter&utm_campaign=may_27&utm_content=link Get Free Weekly Health Tips from Dr. Hyman https://drhyman.com/pages/picks?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Sign Up for Dr. Hyman’s Weekly Longevity Journal https://drhyman.com/pages/longevity?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Join the 10-Day Detox to Reset Your Health https://drhyman.com/pages/10-day-detox Join the Hyman Hive for Expert Support and Real Results https://drhyman.com/pages/hyman-hive This episode is brought to you by BIOptimizers, Cozy Earth, Perfect Amino, Seatopia, Made In, and BON CHARGE. Shop Magnesium Breakthrough at bioptimizers.com/hyman and save 15% with code HYMAN. Upgrade your sleep setup with cozyearth.com and enjoy 20% off with code HYMAN. Help fill protein gaps at bodyhealth.com and use code HYMAN20 for 20% off. Find a cleaner source of seafood. Check out seatopia.fish and use code HYMAN for free shipping on your first order. Shop for kitchen essentials at madeincookware.com and save 10% off your first order with code HYMAN-HIVE. Explore red light products at boncharge.com/hyman and enjoy 15% off with code HYMAN. (0:00) Introduction and Dr. Hyman's health journey (3:11) Challenges and limitations of conventional medicine (5:03) Environmental toxins and chronic illness (7:21) Identifying root causes and treatment order (16:14) Dr. Hyman’s mold struggle, toxicity vs. sensitivity (21:01) Dr. Nathan’s books and diagnosing chronic illnesses (28:53) Treatment strategies: primary cause, gut health, and mold (34:22) Addressing limbic, vagal, and mast cell issues first (39:52) Complexities of treating tick-borne infections (44:46) Emotional and psychological aspects of recovery (45:04) Encouragement and hope for chronic illness sufferers (46:36) Closing remarks and podcast info

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:01Speaker 00

  What makes the nervous system so sensitive? And once you understand that, you also know how to treat it. So when people have developed chemical sensitivity, they're often told, oh, you just have to learn to live with it. My message is, no, you don't. We can fix that for people who developed EMF sensitivity. We can fix that. We've been at this for 20 plus years. We have slowly filled up our toolbox in such a way that we really can help the majority of people who are really sick.

• 0:31Dr. Mark Hyman?

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• 1:16Dr. Mark Hyman?

  a lot harder. As a result, I found myself paying a lot more attention to the fabrics I use every day, especially the ones I'm sleeping in. Cozier's bamboo sheet set has been a game changer for me. The fabric is soft and noticeably cooler, so I'm not waking up overheated in the middle of the night. I've also been reaching for their all-day tea a lot lately. It's soft, it's lightweight, and it still feels comfortable even on long, hot days. Sometimes the small things in your life can have a bigger impact on how you feel than most people realize, especially when it comes to comfort, the sleep quality. If you're looking to upgrade your daily essentials, head to cozier.com/hyman and receive 20% off. All right, Neil, welcome back to the podcast. So good to have you and see you again. We've known each other for decades and decades in dealing with complex patients

• 1:59Dr. Mark Hyman?

  who are struggling often to find a way out of a whole set of symptoms that nobody can help them with, that are persistent and debilitating. And you really have mapped out an incredible framework for understanding complex chronic illness, whether it's mold, Lyme, chemical sensitivities, environmental illness, chronic fatigue, the whole spectrum of things gets sort of dismissed by traditional medicine, or it gets ignored, or that doesn't have great tools for, or any of the above. You really spent your life dedicated to trying to understand why these people don't get better and what the challenges are in treating them and how to actually think about resolving these issues. And you know, you have been one of my mentors, one of my teachers.

• 2:44Dr. Mark Hyman?

  And I think I really appreciated your wisdom and insights and intelligence over the years. And it's all particularly important for me because I personally have had chronic fatigue syndrome. I personally have had Lyme disease and tuberculosis. I personally have had severe mold illness and almost died. I have really had these problems, heavy metal toxicity, mercury toxicity. And I've had to figure that out for myself. And now I feel healthy and good. I just went for a 15-mile bike ride this morning. I'm almost 67. I feel great. My time's about the same as it was, you know, 10, 15 years ago on a loop. So I think, you know, the reason I share the story is like, I think there's hope out there, and you provide a lot of hope. So Neil, why don't we start out by you kind of framing the issue

• 3:28Dr. Mark Hyman?

  of like, why are so many people struggling with all these unexplained symptoms? And why are they so sick without any kind of clear diagnosis? And often they're told their labs are normal, you know, that this is just, you know, psychological. And why is medicine sort of missing the boat on this?

• 3:46Speaker 00

  The way conventional medicine works is based on a concept that is great for simple issues and absolutely doesn't work for chronic illness of almost any kind. It's based on the concept that, okay, I come into my doctor and I've got a sore throat. He does a strep culture. It's positive. He gives me penicillin and I get better. Right. Nice. Simple. But chronic illness doesn't work that way. In the body, everything is connected to everything else. And conventional medicine is based on a one cause, one diagnosis, one treatment model that simply does not fit anymore. The world we live in is absolutely complicated. As I know you know,

• 4:31Speaker 00

  many of the people who come to see us have been gaslit by the medical community. They've been told this is in your head. There's no such thing as Lyme disease. There's no such thing as mold toxicity.

• 4:44Dr. Mark Hyman?

  Yeah.

• 4:45Speaker 00

  And we have helped thousands of people recover their health by knowing that there is another model. There is another way. But another part to your question is, we live in an increasingly toxic world. The, it is now known that there are 350,000 new chemicals in our environment in the last 70 years. The vast majority have never been studied in terms of whether they affect our health or not. And we add to that the increasing exposure to electromagnetic frequencies, EMFs. And so people are rolling out 10G now with no concept that we're being exposed

• 5:29Speaker 00

  to massive amounts of an energy that our bodies were never designed to deal with. So we have an increasing amount of toxicity. Our livers have to deal with things that 100 years ago, no one had to deal with. And they're overworked. And so slowly, the toxins continue to accumulate in our bodies. They trigger inflammatory reactions which become chronic. And we are off to the races in the wrong direction. So I think that's what's happening. And it's really tragic.

• 6:01Dr. Mark Hyman?

  It is tragic. And I, you know, I don't know if you ever experienced any of these problems yourself, Neil, but I suffered it from the inside out. And I almost died from mold. My whole immune system collapsed. I got tremendous amounts of inflammation. I went in a terrible catabolic state. You know, with Lyme disease, I had severe fatigue, brain fog, cognitive issues. And, you know, I developed weird sensitivities to foods, weird sensitivities to chemicals. I would get rashes when I would eat certain things. It was just really strange how my body completely broke down. And I think, you know, I felt so disabled by it. And traditional medicine offered no solutions. And that's really how I got into functional medicine 30 years ago. And I think that a lot of people out there listening have these issues, whether it's, you know, chemical sensitivities or histamine responses.

• 6:45Dr. Mark Hyman?

  We call MCAS now is, you know, basically an advanced form of like, you know, histamine intolerance. We have all these weird autonomic symptoms, these long COVID issues. We have people getting so many tick-borne infections that aren't even diagnosed properly. It's a lot of stuff that is all a big soup. And often it's, people have multiple things at the same time. Like, it's not just one thing. So when you start to think about these patients, you know, and these people who are suffering, how do you start to approach them? How do you sort of help them understand what's happening and kind of guide them?

• 7:22Speaker 00

  Well, the first thing I always look for is root cause. What is the primary thing that's making my patients sick? Unfortunately, there could be several root causes in your case. And I remember talking to you when you were really ill with the mold toxicity.

• 7:36Dr. Mark Hyman?

  Thank you, by the way.

• 7:38Speaker 00

  And you're welcome, by the way. The trick is to identify all of the root causes, not just get focused on one, but also to try to prioritize which root cause needs to be treated in what order. And sometimes that varies from patient to patient. It's not as simple as it sounds. The biggest root causes that we see are mold toxicity, Lyme disease. We can talk about other environmental toxicities as well, and long haul COVID. Those three are the biggies of what we have to sift through. And a lot of physicians or patients get hung up on things that are downstream from that.

• 8:23Speaker 00

  The mast cell activation, limbic dysfunction, vagal dysfunction, methylation dysfunction, mitochondrial dysfunction, recurrent Epstein-Barr or other viruses. And they could get really caught up in that for years, thinking, I'm treating a root cause, but it's really not the root cause. The root cause is something more profound that is weakening that immune system. And that's what we have to really get started on because otherwise, we're just going to be not making any progress.

• 8:56Dr. Mark Hyman?

  I agree. And I think, you know, I noticed this very early when I was in practice, that you have to focus on the upstream causes and you have to keep going up and up and up till you find out what the higher level order of things is, rather than treating the symptoms. And like, you're right, autonomic dysfunction, histamine intolerance, chemical sensitivities. These are the results, not the causes of something. And just to clarify a little bit what you said about mold, about, you know, long COVID and about environmental issues. And you said Lyme, but when you say Lyme, you mean the entire Lyme constellation of tick-borne illnesses? Because there's a million of Lyme, tuberculosis, Borrelia, Bartonella.

• 9:35Speaker 00

  I mean Lyme and its co-infection buddies.

• 9:38Dr. Mark Hyman?

  Yes. I knew you meant that. I just wanted to clarify. Because not everybody just got a flu to this as we are. But I think, I think this is actually such an important point. And you highlight in your book, and you talk about this, the importance of doing things in the right order. That you can make someone sicker by doing the right thing in the wrong order. I wrote an article like, probably 20 years ago, called "The Right Order of Things", which is exactly this. You know, start with the basics, then you kind of layer in. If you start doing some things that might be helpful to someone later on, early on, it could make them worse. So can you kind of explain that whole phenomena? And why we have to sort of be sort of structured in how you approach these problems and not get people sicker?

• 10:18Speaker 00

  By the time people reach me, many of them were like you at your worst, in which they're really exhausted, can't think straight, anxious, reacting to everything. And in that state, it's especially important to do things in the right order because if you do it in the wrong order, they're going to get worse. And that order has to be figured out. For most people, starting with mold toxicity is the right order. For one major reason for it, and I'll give you several. One is mold toxicity looks like Lyme disease with its co-infections, looks like long haul COVID.

• 11:03Speaker 00

  And that's why teasing it out by symptoms is impossible. So if we know someone has mold toxicity, which has shown up very clearly on a urine mycotoxin test, the other are a little bit harder to diagnose by test. The easiest one to test for is mold. And if you have a mold positive test, that's a great place to start. We know it with certainty. A lot of the time, if we get rid of the mold, the people get either completely well, which means we don't have to go down the Lyme rabbit hole, or they get 70% better. And what's left symptomatically helps us hone in on what's the next layer that we have to be treating. So typically, I will start with mold.

• 11:47Speaker 00

  But having said that, it is more complicated than that. Because for most of my patients, mold toxicity will trigger limbic, vagal, and mast cell dysfunction. And those all represent, from the body's perspective, safety or lack of safety. And we know that if a body doesn't feel safe, it can't heal. Not psychologically, physiologically.

• 12:13Dr. Mark Hyman?

  You talk about the cell danger response. That's what you're talking about, right?

• 12:16Speaker 00

  I am. That is correct. Often, in order to even get to treating the mold, many of our patients are so sensitive, they can't take the supplements they need, the binders that they need to take to even begin that treatment. So for them, we have to start with limbic and vagal rebooting, then add mast cells, which is present for most of them. Then we can get into the mold. Once we pull that layer off, then we can see whether or not there's a Lyme or long haul COVID piece to it and get going on that. If we approach it that way, we will make progress. But I've had countless patients spend years

• 12:59Speaker 00

  working on Epstein-Barr or mitochondrial dysfunction, methylation dysfunction, and getting nowhere.

• 13:05Dr. Mark Hyman?

  Yeah, because those are downstream.

• 13:06Speaker 00

  Not only is it downstream, in a state of cell danger response, which for your listening audience, cell danger response is a concept developed by Bob Navio. It's a brilliant way to understand the complexity biochemically of what's happening in almost every chronic condition. And on a simplistic level, on a cellular level, which extends to the whole organism, if someone is experiencing infection, toxins, or stress, or combinations of those, the cell shuts down in order to contain the infection, to deal with the stress, which extends to the whole body.

• 13:47Speaker 00

  And until that gets addressed, you're not going anywhere. And that is not psychological. You can't just decide, oh, I'm going to be better. You have to literally get the body better so it experiences that I am safer. The threat is either gone or almost gone. Now I can proceed to healing. So that helps us to understand, again, what to do in what order. Because you're in the first phase of cell danger response, the body will not respond to methylation or mitochondrial treatments. It won't respond to plasma exchange. It won't respond to peptides. It won't respond to much of that.

• 14:30Speaker 00

  It's basically going, hey, I'm on survival mode. I, that's a lovely thing you're doing for me. I can't deal with that until I'm safer. So that's how I conceptualize the order in which we treat.

• 14:45Dr. Mark Hyman?

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• 15:29Dr. Mark Hyman?

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• 16:13Dr. Mark Hyman?

  Yeah, it's tough. I almost died from mold. I'm in this barn where you can see the background. It's an old 125 year old barn. It was super moldy. I was coughing for a year. I was working really hard. I was doing Cleveland Clinic and I was just kind of ignoring my symptoms. I kind of knew something was up. The house kind of smelled a little moldy. I was like, oh, maybe something's going on. I checked it out and sure enough, it was full of mold. I moved out, but I ended up getting this cascade of things that happened where I had a root canal removed. I had an antibiotic, gave me C. diff, and my whole system collapsed. And, and I went into this massive inflammatory cell danger catastrophic, catabolic state where I was in bed for five months.

• 16:56Dr. Mark Hyman?

  And I lost 30 pounds and I couldn't eat and my whole colon and gut were all inflamed. And, and it was tough to get out of that. And I think, you know, for some people, you know, the question is, what are the, what are the right levers? And where do you start? And for me, I was doing all the dietary stuff. I did all the supplements, everything I could do. I thought I was doing all the right things. But it turned out I had to, and it sounds kind of like a crazy option for people. But I heard one of my patients, and I usually listen to my patients because they usually, they report what works out there in the wild. He said, I did ozone. I had really bad mold poisoning and I did ozone and it helped me. I'm like, okay, well, maybe I'll try that because I'm dying. I don't know what else to do.

• 17:38Dr. Mark Hyman?

  And I did it and it was like literally in two days, it snapped me out of it. I don't know how it exactly worked, but then I kind of continued on to a mold detox. And I think, you know, the phospholipid exchange I find really helpful too, which is a whole different approach that was developed by Patricia Kane and others that uses high doses of phosphocole choline intravenously, along with glutathione and methylating nutrients and other minerals to help mobilize the toxins. And I found that extremely helpful and I find it helpful for a lot of patients. So those, there's a lot of things that are in the toolkit for people, but you kind of, you know, I think what you're talking about, Neil, is that you really have to have the right map for people and really think properly about this. Maybe we can kind of back up a little bit and talk about this phenomenon of toxicity versus sensitivity.

• 18:23Dr. Mark Hyman?

  What's the difference? And how does, how does this shift happen from like being tolerant of things to being intolerant? Like people get intolerant to food, the smells, the light, the sound, like react to everything? So how, how does this work?

• 18:35Speaker 00

  Sensitivity refers to something neurological, like our senses, all of our senses, touch, smell, hearing, light, sound. So sensitivity refers to sensitivity to light, sound, touch, smell. Toxicity is, there's a toxin in our body, which is inflaming our body on a systemic level. So it's helpful to separate that out. And we can do that just by talking with our patients in history. One of the things I ask every patient is, have you developed any sensitivities? And we ask ones specifically. If they have, they're already telling me that their limbic and vagal systems need help.

• 19:18Speaker 00

  Because the key to sensitivity is the limbic system. That's the part of the nervous system that specifically monitors our sensitivities and gets out of whack when it is inflamed by anything. Mold toxicity is the biggie. That's the one that we see the most. So by listening to the patient, if they're telling me that I can't think straight, I'm cognitively impaired, I'm fatigued, my joints and muscles hurt, that's generalized inflammation. You can call that the toxicity category. Sensitivity is those senses are on high alert.

• 19:58Speaker 00

  And people become exquisitely sensitive to smell, for example, where they can smell mold, for example, and nobody else in the family can.

• 20:06Dr. Mark Hyman?

  Yeah, like a mold dog. I have that. I can walk into a room and I'm like, oh, moldy.

• 20:11Speaker 00

  Well, dogs have, we know, have a sense of smell a thousandfold greater than ours. But even humans can develop some of that when their limbic system gets flight enough. And you know, I, I knew you when you had lost 35 pounds and you do look. Much better.

• 20:32Dr. Mark Hyman?

  Thank you.

• 20:33Speaker 00

  Now than you did back then. It's good to see.

• 20:36Dr. Mark Hyman?

  It's, it's, it's, uh, it's amazing the body's recovery capacity. And, and if you, you know, for people listening, it feels hopeless. And I know people struggle with these conditions, never feel like they get the answers, but, but there is a framework for thinking about this. And your book is such an important contribution to the field. It's called Toxic Kill Your Body From Mold: Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness. And it's, you wrote it and then you re-did it and updated it in a second edition, which includes the EMF sensitivity, environmental toxins, COVID, long COVID. I, I think this is, is really important. And I, I personally use the book. I think it's, it's such a detailed resource for understanding these chronic illnesses and for giving hope to people who really struggle.

• 21:20Speaker 00

  So I would, I would add to that. Um, I, I wrote a book called The Sensitive Patient's Healing Guide, which focuses on the sensitivity component. And I have 20 experts who contributed to that book, where we go over what makes the nervous system so sensitive. And once you understand that, you also know how to treat it. So when people have developed chemical sensitivity, they're often told, oh, you just have to learn to live with it. My message is, no, you don't. Um, we can fix that. For people who developed, um, EMF sensitivity, we can fix that. So these are, are things that now

• 21:59Speaker 00

  that we understand how the body physiologically becomes more sensitive, we also have the capacity to fix it. So I want to really emphasize the hope that you're referring to, which is, um, you know, we've been at this for 20 plus years and we have slowly filled up our toolbox in such a way that we really can help the majority of people who are, who are really sick.

• 22:24Dr. Mark Hyman?

  So let's talk about, you know, the, how we diagnose these things and, and how we treat them and what works and what doesn't work. And I think, you know, it'd be helpful to kind of, you know, get your perspective because, you know, the, this cocktail of chronic, kind of persistent, um, illnesses. And I, I would say if I, as a doctor, if I could, if I could do two things, it would be to get rid of mold and Lyme-related illness from the planet because they cause so much suffering. Um, and, but we have to deal with it. And, and the question is, you know, traditional medicine doesn't really, it, it sort of acknowledge these conditions. The diagnostics are really not used. What, what are the diagnostics that you use to help figure this out? And then

• 23:08Dr. Mark Hyman?

  let's talk about, after that, some of the, you know, the, the right ways of approaching this from a treatment perspective.

• 23:13Speaker 00

  For mold toxicity, there are four labs that will help make the diagnosis. Three of them measure mycotoxins in the urine and one measures the, the, an immune response in the blood to it. Any of these tests, a positive result will really point us in a direction that you do have mold toxicity. Although people argue that you can get this from food ingestion, that's not been my experience. And I can give you reasons why that.

• 23:41Dr. Mark Hyman?

  So you think, yeah, because people dismiss it. They, oh, this is just toxins from food. It's not really real when you.

• 23:45Speaker 00

  It is not. Does it contribute a teeny bit to maybe having it in your urine? Yes, but not to an extent that we wouldn't pick it up on our testing. Uh, so urine mycotoxin to me is the standard. Anyone who presents with a complex illness should get a urine mycotoxin test. If you want me to talk about brands or which ones are better than others, I'm happy to do that, but I can otherwise leave it alone. Bottom line is, you need a good test to measure.

• 24:13Dr. Mark Hyman?

  So you're saying urine, urine mycotoxins. And, and then there's also a whole field of, of, you know, Richie Shoemaker, who's one of the pioneers in mold, um, related illness, has, has a phenomenon he talks about called SERs. So there's a lot of biomarkers that are used, including, you know, I MSH or C4A or TGF beta one. These, these are like blood tests that you can get. Are they useful? Are they helpful? Do they not matter?

• 24:36Speaker 00

  So number one, if you're interested, I've just finished a podcast with Richie in which we discussed the differences in our approach. And about a two and a half hour podcast that we did with Scott Forsgren and his Better Health Guy podcast. So if you want a excruciating discussion of the differences, that's going to be available. And I'm really happy that we've been able to do that. All those tests that you're measuring, their blood tests, uh, TGF beta one, C4A, MMP9, VEGF, they're indirect measures of inflammation. They're helpful in telling us, yes, you're inflamed, but they will also be positive, not just for mold, but they'll be positive in Lyme and co-infections,

• 25:21Speaker 00

  other infections, some viral infections. So if you want to document that someone is inflamed, they're helpful. Will they pinpoint mold? They won't. The urine mycotoxin test is absolutely specific for mold. And forgive me, it's not rocket science. If you're peeing out mycotoxins, they're coming from your body. You've gotten them into your system. So if we are, we can measure, uh, significant amounts of mycotoxins, mold toxins in your urine, you have it. There's no, forgive me, there's no really question about that. To me, that is the single most useful test

• 25:59Speaker 00

  to help put this away. It's very accurate, um, and very useful. Then, in the Lyme field, our testing has improved. We've gone from the fairly inaccurate, um, serologies and Western blot to much more accurate immunoblots that measure many more species of, um, Lyme and Bortinella than we used to appreciate before. And there's some newer testing, which I'm really fond of. Bob Mosiak has a T-LABS test where you can send a specimen of your blood and you can look at it under the microscope with a special fluorescent stain that only stains that particular

• 26:41Speaker 00

  microbe. And it will tell you, is this in your body right now? And I find that, that a particularly useful test, because our serology tests are testing our, our immune system.

• 26:53Dr. Mark Hyman?

  Like when you look for antibodies, it's not, it's not always helpful. So what, what is he measuring with this test?

• 26:58Speaker 00

  It, it's helpful for, the immunological tests are great for, for helping us to, to know you have it, or mostly that you've been exposed to it. But even when you're cured of it, your body's going to still make those antibodies because of what we call immune memory. The same concept that we use to, for all of vaccinations is immune memory. So what I always want to know is, okay, I've made the diagnosis. How am I coming with treatment? Have I gotten enough of the bugs out of the system so that this, we don't have to keep treating and I don't have to keep using antibiotics? And for me, the T-LAB test is very helpful with that. I'll give you one other test

• 27:39Speaker 00

  that I'm currently very fond of, which is, uh, Bruce Patterson's Radiance Lab does a test for 14 different cytokines. Cytokines are, the result are what our immune system triggers in our body when we're fighting these threats of toxins. And it turns out, especially from Dr. Patterson's research, that there's a different pattern of cytokines in Lyme. There's a different pattern of cytokines in long haul COVID, so that we can identify that much better. And I'm doing research with him right now, which we're identifying a different pattern yet from mold toxicity. So

• 28:21Speaker 00

  with a single blood draw, what you can look at is, what is this immune system fighting right now? What cytokines is it generating in a pattern that would immediately make me think, oh, this is a long haul COVID pattern? And it could be all of them together, because we see that really quite commonly. So we are now evolving much better tests than we had 20 years ago to begin to hone in on, um, which of these is the biggest issue here and what do I need to treat first?

• 28:53Dr. Mark Hyman?

  So the tests, we can look at mold urine toxins. We can look at different immune responses to tick infections. There's ways to look at heavy metals. There's ways to look at toxin load in the body. It all sort of gives you clues about what's happening. In, in the treatment of these, these patients, do you, you often start with like lifestyle, diet and the gut? Or do you just kind of right to the, what you see is the sort of the, the trigger, which would be like the, the mold?

• 29:17Speaker 00

  Or? My bias is to start with the primary cause. I have had a lot of my colleagues start with, uh, improving detoxification strategies, getting the diet built up. But the problem is, the vast majority of patients who have mold toxicity have ZBO. They have intestinal dysbiosis. And you, you can't fix that until you get the mold and candida out first. And one of the major tenets of functional medicine is fix the gut first, everything will follow. The exception to that is mold, which is if you have mold and candida almost always comes with mold

• 29:57Speaker 00

  and you're not working on it, every strategy you use is likely to not work well. You can, our patients will respond to effects and then they'll get better for a couple of weeks and then they'll go right back to where they were. So my approach is to get going on the causation first. And honestly, once you get that out of the system, the body's innate healing powers will fix most of anything else later. And if it doesn't, then we can use our normal tests and go, okay, you're deficient in zinc and selenium. I can give you these and those will be helpful to you. Um, I can look at your fatty acid imbalances and we can balance that out.

• 30:39Speaker 00

  But you'll respond infinitely better if you get rid of the primary driving root cause first.

• 30:46Dr. Mark Hyman?

  So let's talk about that. Like we talked about sort of diagnostics and it seems like, you know, mold and ticks, I definitely are things I think about with every patient who's got anything that's chronic, even if it's autoimmune disease. I mean, it doesn't have to be chronic fatigue or histamine intolerance or any of these other things. It can be like an actual disease that didn't realize. For example, I had, I had ulcerative colitis. That's what I got, you know, but that wasn't really the problem. The problem was the mold. Uh, and as soon as I got rid of the mold.

• 31:13Speaker 00

  You may not know this, but me too. I also got ulcerative colitis from my mold. So.

• 31:19Dr. Mark Hyman?

  Wow. Okay.

• 31:22Speaker 00

  Brothers from another mother. What can I tell you?

• 31:24Dr. Mark Hyman?

  Tell me about it. Oh my God. That was the worst. I was having 20 bloody mountains a day. I lost 30 pounds. I couldn't eat. I, my whole intestine was inflamed and it wasn't until I really got the mold sorted that, that helped. But I'm curious, you know, when you have someone with this complex illness, like somebody like me, like where do you, what do you do if you're not starting with the gut first, if you're sort of taking a little bit of attack, you're going right to the root cause, what are the therapies, what are the modalities, what are the treatments that you find most effective in these complex chronic patients and, and, and including mold, but also we all want to talk about the tick stuff a little bit.

• 31:56Speaker 00

  Sure. First, I think this is central. We start with a good history. Again, when we were talking about why conventional medicine often doesn't get anywhere, it's, you know, my, um, my histories are two hours long. Um, so you really have to really listen to the patient. They will usually tell you what's going on. If you just sit back and listen and don't interrupt their story. If you don't chime in or, or push it. But then, once you hear their story, then you can really dig into some of the details, asking them about, as in your case, uh, do you have any mold exposure?

• 32:36Speaker 00

  Do you smell any mold? Do you have a, a barn or is something nearby that might have mold hay in it? Just saying. Water damage building, water. You start asking these questions. As I said, I ask every patient about their sensitivities. As soon as they start saying, yes, I'm sensitive to light and sound and smells and chemicals. I already know they've got a limbic issue and we're going to need to address that early on. If we don't, we're not going anywhere. I'll ask about mast cell activation early on. I'll ask them about, do you ever get a reaction to anything you eat or drink immediately? There are other manifestations of mast cell activation, but

• 33:19Speaker 00

  that's a tip off. When someone says, I get immediate bloating and gas while I'm eating it, I don't even have to finish it. Great. I already know you have mast cell activation, that that's a piece of it. And then I look for the vagal piece as well. I'm looking for autonomic nervous system symptoms, palpitations, temperature dysfunctions, the vagus controls the gastrointestinal tract. So I'm looking for any GI symptom, probably has a vagal piece to it. Um, POTS, um, you know, low blood pressure are all things that will tip us off to there's a vagal piece to it. So I'm

• 33:58Speaker 00

  trying to, as I listen, put together in my mind, what was the root cause? What has it triggered? What are the downstream pieces? So I can then formulate, um, my bigger picture. So yes, I always want to treat root cause, but for many of our patients, I can't treat root cause until I deal with the limbic vagal mast cell systems first.

• 34:21Dr. Mark Hyman?

  And how do you, how do you deal with those things first?

• 34:23Speaker 00

  Well, for all of those, each of those has their own treatment. So for the limbic system, there's a number of very excellent programs out there that patients can do to do the reboot. Uh, there's Annie Hopper's Dynamic Neural Retraining Program. There's Ashak Gupta's Amygdala Retraining Program. Amygdala is another word for limbic. Uh, there's Kathleen King's Primal Trust. Those are three of my favorites. And there are some others. On the vagal side, there's a bunch of new devices on the market called vagal nerve stimulators. Got to be careful with them. My sensitive patients can't take the most direct stimulation. There are devices

• 35:04Speaker 00

  like gamma core, which go greatly over your neck. There are devices that attach to the ear lobe, which is a branch of the vagus. Most of my patients need to use indirect stimulation. So I use apollo neuro a lot to, to help reboot the vagus. I love osteopathic cranial work for the vagus. I love frequency specific micro current. And then there's virtually anything that quiets the sympathetics, uh, tai chi, yoga, meditation. Um, they're all excellent, but it usually takes several vagal strategies coupled with limbic to move people off from the super sensitive bedridden

• 35:49Speaker 00

  into more functional and then able to do more. Then we get from mold into taking binders that are specific for what we see in their urine. So we know that whatever mycotoxins show up in your urine, we have a table, um, in my book, Toxic, there's a big table that shows what we know from the medical literature of which binders work specifically on which toxins. You can literally look at your report and figure out, okay, I'm going to need charcoal, clay, chlorella, and well, chole or cholesteramide to get this out of me.

• 36:27Dr. Mark Hyman?

  So there's specific, there's specific binders for specific mold toxins, what you're saying?

• 36:31Speaker 00

  Yes, we can, we can make precision medicine out of this. And then for many of our patients, not only do they have mold toxin, they've colonized. The mold has actually colonized in their sinus, gut, or sometimes their lungs. And we're going to need to use antifungals to get rid of those. So that's the mold treatment.

• 36:52Dr. Mark Hyman?

  Those binders and antifungals, do you also add in things like ozone or phospholipid exchange or other therapies?

• 36:59Speaker 00

  I know, I know the ozone worked for you. It doesn't work for most people. Um, it's much more effective known for Lyme and co-infections than for mold. I love phosphatidylcholine. I think it's great. It's one of my favorites. I mean, I, I also use dozens and dozens of, uh, I will call them naturopathic approaches to treating mold, other naturopathic binders, things to improve the gallbladder's ability to function better, the liver's ability to detox better, the kidneys' ability to detox better, saunas to get toxins out of the skin better. So, um, I've,

• 37:43Speaker 00

  I've intentionally oversimplified it, but it's, um, we have tons of tools at our availability to help people aided in their journey to pull these toxins out of their body.

• 37:56Dr. Mark Hyman?

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• 38:41Dr. Mark Hyman?

  to maidenware.com and use the code hymen-hive for 10% off your first order. Most of us are walking around in a state of chronic stimulation. Your cortisol is elevated, your nervous system is stuck in go mode. And we wonder why we can't sleep or focus. And one thing I've been using that I generally look forward to at the end of the day is the infrared PMF wrap from Bone Charge. PEMF, otherwise known as post electromagnetic field therapy, delivers gentle electromagnetic frequencies into the body that mimic what you naturally absorb spending time on the earth. Combined with red and near infrared light, it's one of the few recovery tools that works while you're absolutely doing nothing. I throw it on for 30 minutes on reading or winding down, and I notice I sleep better on the nights I use it. It's

• 39:26Dr. Mark Hyman?

  lightweight, it's low EMF, it's free shipping, HSA and FSA eligible. And honestly, one of the simplest things I've added to my evening routine. So head to boncharge.com/hymen and use the code hymen for 15% off. That's B O N C H A R G E dot com slash hymen and you'll get 15% off. And what about, what, what about the tick stuff? Cause the mold, binders, antifungals, there's those phospholipids, there's a lot of great therapies. Tick infections seem harder and more treatment resistant.

• 39:55Speaker 00

  They are harder and they're harder on the body because in my experience, most people won't get well with herbs alone. Most people, they're helpful and I use herbal approaches, but for most people, they'll need an antibiotic approach for a longer period of time than anybody wants in order to really get them free of that particular micro. Unfortunately, the same antibiotics don't work the same for the different co-infections. So we'll use certain antibiotics for Lyme itself, others for Bartonella, others for Babesia, and then there's the, the lesser known ones of Anaplasma, Arlechia, et cetera. But, um, I mean, it's a whole field,

• 40:38Speaker 00

  as you well know, there's a whole group of physicians that are called LLMDs, which is Lyme literate MDs, in which, um, we've all had to study this because it's, it's not as simple as that strep infection thing I talked about where you have a strep throat and you take an antibiotic for a week and you cure it. Doesn't work that way with these bugs. They're way more complicated. So the whole Lyme field, I think, is more complicated, but again, it takes a whole armamentarian of things that work on these particular critters to get them out of the body. They're what, they're called stealth infections. They hide inside our, our cells. They're not

• 41:23Speaker 00

  just floating around in our bloodstream there. We have to literally pull them out of the cellular location and get at them, which is, forgive me, complicated.

• 41:35Dr. Mark Hyman?

  Yeah, it is. It is. And I think, you know, I think, you know, we're talking about how we can get people better. Um, and, and you dealing with the, the patients that are at the end of the road. And I, I have most of my career as well. My joke was I worked at a health resort and I'm a resort doctor, but the doctor of last resort. I think you are too. Are there people with these complex chronic illnesses that you just haven't been able to help? Like, are there people who just are so stuck in their biology? They can't kind of correct it? Because what happens, I see in the biology is it's sort of stuck in this feed forward cycle. And I was caught in that and I couldn't get out of it. It was like a, it was a loop. No matter what I did, I couldn't break it.

• 42:15Speaker 00

  I do. I don't think there's a physician alive who can say they cure every person they ever see, and I'm certainly not one of them. I would say I've helped the vast majority of people I've worked with, but I certainly have folks that I haven't helped. And then I'll give you some reasons for that. In the mold field, the single number one reason that people aren't getting better is they haven't been able to get out of a moldy environment. They haven't been able to remediate their home properly, still in it, they financially can't afford to leave. And if you can't get out of the mold, you can't heal. So that's

• 42:51Speaker 00

  the biggie. For, for other people, I think that are really sick, there's often a spiritual, emotional, psychological, or energetic block in which there's something else going on preventing them from responding to the treatment we're giving them on a deeper level. And, and that requires an even more in-depth work with the patient of figuring out with them. I'll usually say to them, you know, you're not responding to what I'm doing. Do you have any ideas about where you, where your block is or where you're stuck? And most people

• 43:35Speaker 00

  have an idea. Most people will say, well, you know, I had all of this early childhood trauma, and I never, I worked through some of it. I'm not sure I worked it out. And what I find is, if we then do get into that, and that might take another year before they're even able to get back to treatment, then they can proceed. But we have to find the block. I call it the block, where there's energetically, there's something blocking energy flow in the body. There are some energy healers sometimes who can do some great work in that regard, getting things. We just have to look deeper. Sometimes, and I don't love

• 44:14Speaker 00

  to talk about it, some people don't have the will to live. They get so sick and they just decide, I'm giving up. And that way of thinking prevents whatever they're doing from having any beneficial effect. So this, it becomes really complicated. And our, our goal as physicians or as would be healers, is to dig as deep as a patient will let us to find what they need from us to move them forward.

• 44:46Dr. Mark Hyman?

  Yeah, I think that's really important, Neil. I mean, people get discouraged, disappointed, and frustrated, and sometimes suicidal. And I definitely found myself there at different moments and different illnesses that I had. And I was like, I can't do this anymore. But, but I think hopefully people take away from this conversation that there is a way to think about this, that there is a roadmap, that there is an understanding of what's happening when people have these chronic complex illnesses. That if you're struggling, don't be hopeless. There, there is a way through it. I think I, I would encourage everybody to get your book and follow you on your social media, on Instagram and your website, neilnathanmd.com. And the book is, you know, is called Toxic Heal Your Body From Mold Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Environmental

• 45:31Dr. Mark Hyman?

  Illness is out now. And Neil, thank you for your dedication, your work, your, your, your teaching of me, your helping of me when I was sick. And, and I think, you know, you and I are both proof that there is a way out of this. We've both been very sick with this and probably motivated a lot of our work. And, and, and then there is, there is a way to think through how to solve these chronic complex illnesses. So thank you so much for your career and work and dedication and all the things you put in your book.

• 45:58Speaker 00

  Thanks. My take home message is, everything we talked about today is treatable. And so, yep, there's hope.

• 46:06Dr. Mark Hyman?

  Absolutely. And I'm a living example. I've had all of it. I've had mold, I've had mercury, I've had Lyme, yeah, everything. You're right.

• 46:14Speaker 00

  And still, and still here to laugh about it.

• 46:16Dr. Mark Hyman?

  I'm still here. I'm feeling great, actually. Actually, I feel better than I felt ever.

• 46:20Speaker 00

  That's, that's wonderful. Fabulous.

• 46:23Dr. Mark Hyman?

  Yeah. All right, Neil, take care of yourself and we'll talk soon. If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to the Dr. Hyman Show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health, where I am Chief Medical Officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only

• 47:06Dr. Mark Hyman?

  and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at ultrawellnesscenter.com, and request to become a patient. It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.

• 47:49Dr. Mark Hyman?

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