 Just a few housekeeping things, please feel free to share if you find this content helpful. We will be recorded so if you miss part of it, you can always watch it later and be sure and ask your questions. I'll be keeping a little bit of an eye on the feed. So if you have questions, we'll try to answer some of those live as well and as always, totally excited to have you here. If you want more information about myself or any of the information I write about, you can find that on my website, which is jillcarnahan.com and you can find retail products at drjilhealth.com. So I want to introduce my guest today. I'm so excited to be talking to him, colleague and friend Dr. Conan Shaw and Dr. Conan Shaw is a certified functional nurse and practitioner and board certified clinical nutritionist with over 20 years of experience and I'm going to read the rest of his blog, but I want to tell you something personal. I remember we first talked a couple years ago and it was really really neat for me to talk to him on the level the kinds of complexities and patients that he sees and realize he is as bright, as smart, as incredibly brilliant at these complexities as anyone I've ever talked to. And I think I told him that at that time just being like, wow, you really know your stuff. And he's so humble, he won't tell you that so I get to tell you. But he is a really really smart guy and you're going to hear that in these conversations because the stuff we're going to talk about today, Lyme disease, mold related illness, mCAS, trauma, etc. These are complex things and there's not a lot of doctors on that level that really understand how they all meld together. So I always get excited on our conversations because we go deep and we kind of almost can bypass some of the superficial things and go right into the deep complexities. So he works with individuals who to help them achieve their health goals, I know he gets to the root cause of illness and he uses this integrative medical approach, specializes in treating the why behind the broad spectrum of health issues. He looks at deficiencies in flow metabolism, gastrointestinal issues, mood-related concerns, cancer, chronic fatigue, complex autoimmune disease, and as we talked about Lyme and mold related issues. And what I find so interesting, Dr. Shaw, is we talked about this right before we started to go live. You know, Lyme and mold, we didn't choose them because we probably wouldn't have chosen them. They're too complex and hard to treat, but they chose us. So I would love to hear, yeah, a little bit about your story. Like, first of all, how did you get into functional medicine and then how did you get to be where you're at in Lyme country and treating these complex patients? Thanks for, I appreciate you having me here as well. It's fun to chat live. I think like a lot of functional medicine doctors, I stumbled into functional medicine by having an experience that was a little bit challenging. And I learned about functional medicine through a personal experience to make that somewhat long story, rather short in pre-med. I had it. And before we know and stay in ability. Hey, there we are. Can you hear me? Where did you lose me in my story? Yeah, I think we got a little frozen. No problem. I was going to stay live or restart. No big deal. So we'll just restart. I just heard the very beginning, like maybe sentence, and then we lost you. Okay. So I had in undergraduate school had a DPT MMR shot. Did you catch that part? Yeah. And then I had a very, very traumatic time with that. And my first introduction to mastile activation syndrome actually had acute, acute hives, terrible reaction with hives. And I was medicated for that for about six months. And I was not actually skipped my claritin was the new drug at the time. And I skipped. I missed a day and then I hospitalized with hives head to toe. And my sister was in chiropractic college, sent me to a nutritionist who had studied under Jeff Bland, which was interesting. And he changed my diet and gave me some liver and colon support in seven days. I was asymptomatic without, without medications. So that immediately was tossed into the mindset of what, so I called and asked, asked him what was going on. And he said, well, was claritin treating your symptom or treating the root of the problem? And I was like, oh, my gosh, here we go. Right. So that started my journey in the functional medicine early on. And then it was, you know, 20 some years later, the Lyme, Lyme caught up with me in a, in a vicious, vicious way. And so I learned rather personally and very quickly about the trials and tribulations of biotoxin for illness. Wow. So yeah, so you had to deal with some of that yourself. I understand that journey very well, because it's all the same with mold and Lyme myself too. And when it comes, you know, it's again, the complexity of mold related biotoxin and Lyme, and there's a lot of similarities in many of the people we see have both. But the complexity there, I don't think there's anything else that we do that's more complex. Would you agree? It's so deep in the, the potentials of the, you know, when people are suffering from the immune system doing what it's designed to do, it's an incredibly complex puzzle to unwind, no doubt. So I totally agree. I would love to know, like, so say a patient first comes in, and you're doing the interview, obviously you start with good questions and stuff. But what's your kind of initial approach? And then if you do find they have these layers, where would you go? What would you treat first? How would you do that? Wow. So when a patient comes in, you know, a difference between the, I guess you and I are always chasing self regulatory mechanisms, right? So allostasis or the body's ability under stress to reset itself to normal. And when someone can't reset to normal, there's either an infection or a toxin hormone dysregulation or immune confusion or a combination of those four things together. So once you try to differentiate, is it an infection or a toxin? You ask a number of questions or exposed to chemicals? Do you have them albums? Right? You know, you start looking at some genetics. Do you live in Western Pennsylvania and do you run in the woods? Right? I mean, but see the ideas, then you start some line of testing to kind of confirm I am somewhat of a diagnostician, but I almost feel patients who are really suffering on that spiritual level that there's so many layers almost, it's almost intuitive that you know, you're getting into something kind of deep, right? So then I try to differentiate between the type of biotoxin that it is, are they moldy or limey, right? Which is like, which came first, which is more, you know, yeah, totally agree with you there. And then if you get into the biotoxin space, or I know when I get into the biotoxin meaning toxicants are manmade chemicals and biotoxins are are toxins from living things, right? Like a mono or a lime or a mold, any of these kind of stealthy viruses and bacterial infections. I attempt to, I attempt to figure out what's the most dominant pressing issue that's suppressing the immune system, right? And usually, the consideration of emotional trauma comes into that as well, which I know that you dive into with your patients. But so the first is assessing if it's lime or they just align patient. So in my Butler County, Pennsylvania, we're the top percentage of lime diagnosis the last two years in a row in the country. So patients who come in who have strange symptoms, you almost go to lime, right? You just kind of start thinking, oh, maybe this is a limey thing and you start testing. But is it a lime patient? Or is it a lime and patient? And usually, and I love my lime patients who are just mine. Yeah, that's easy, right? Relative. It's so easy. There's no cytomethylviruses, no mono, right? There's no trauma. There's no physical trauma, right? There's probably see some that come in with their bullseye rash, which we don't always see like in my part of the country, Colorado, they've been bit by like the ticks from tick-borne relapse, hermici and myelomati and some of the ones that do not even cause a rash. And so I actually rarely see an acute rash because I'm in a non-endemic state. So you probably actually see some acute cases, which those are easy, right? So there's tier one, tier one is this new, you can go to IgM and IgG testing and kind of feel that out as well, where a lot of people don't have the rash, right? Yeah, yeah. I think it's about 30% actually due. Is that the statistic you've heard? So maybe 70% don't or something or a lot less. I've read so many different opinions on that and I guess no one can really qualify and quantify, but very few people have the real life, not just the spin, I don't know secretions that it's seen in this, Jen. We're missing you just a little bit there. I might need you to repeat what you said there, if you froze, see if we can get that. Hopefully we can get Dr. Conan right back on here. Looks like we're having a little technical difficulties, but I will just speak until he pops back on here. I think one of the things he was saying is that with tick-borne infections and Lyme disease, there is a transmission that isn't always so common as what we typically talk about with the bite. So you were saying something really important. It's always like this most incredible pearl and then we lose you. So go ahead. I can hear you now. And you were saying, I think you just started about, we were talking about the rashes and how they're not that common. And then I heard little bits about transmission. Go ahead and just repeat that. Oh, okay. So deer tick is obviously what most people expect, but it's been identified in spiders, mosquitoes and national secretions and semen and contaminated food as well. And so it's not quite as I had a bite. I had a rash and I had a fever and I had a flu. That patient is the slam-dump diagnosis. The doxycycline kills 90% of the spirochetes and the bacteria in the blood streamer spirochetes kills 90% of those. And amoxicillin kills 80% of those. And those patients are rather easy because there's a bit of a cleanup from the antibiotics. You just do a little bit of support, but usually, and most physicians agree that that patient is a candidate for antibiotic therapies and usually is well responsive. Unless you have that postline syndrome kind of genetic predisposition, you tolerate antibiotics rather well and you're over it. Yeah. Yeah, I've seen actually again in Colorado, it's very unique because I don't see all the classical. So what I see is a lot of people are horse trainers, horse riders with horses a lot because the horse are transmissible vectors, dogs, which we all have dogs in Colorado. So dog owners and dogs that go hiking and camping. So not that they're always transmitted by animals, but especially in Colorado, I've seen a half a dozen or more patients that are specifically working with horses all the time. The second thing I see is the tick-borne relapsing fever because it's more endemic in Colorado, Utah, Wyoming, Texas. It's more in the Western States. It's very unusual and that these ticks will come from a log cabin, your body heat at night. So you might go camping in the woods and take a little secluded cabin that you've rented and these ticks are there along with the mice as a vector and they'll come out at night, bite you in your bed or sleeping bag because they fill the heat and they'll go back and within 15 minutes they can transmit that. You never have a rash. You never know you were bitten. And so it's this thing that you never knew that you ever had. And I've seen some of those be the most difficult cases because any typical Western blot for Lyme, except hygienics, which does specific tick-borne relapsing fever, titers will miss it. No one's testing for tick-borne relapsing fever and they're certainly not testing for 11 strains like hygienics. And I have no ties with hygienics. I just know that they are the lab that does tick-borne relapsing fever well. Other labs do the regular ones well. But back to Colorado and then I've seen lots of spider bites, all kinds of different spiders that carry different things, babesia, bartonella, even some of the Lyme type illnesses, ehrlichia, anaplasma, etc. So I see definitely like you, very unique. It's not the classical woods and Pennsylvania and the Rhode Island and Connecticut type of patients. So let's talk about when you say the tick, the Lyme patient, what would be the symptoms that would clue you in? What would be kind of the things that would make you think about that as a diagnosis? Just to piggyback on what you were saying before about the mysterious bite that no one knows they got the rash for. The other side about Lyme with these stealthy infections is, from what I understand, Lyme has 23 different ways to outsmart the immune response, to sheath itself from 8 years back. And so people say, oh, I had a tick bite three or four years ago and their symptoms of Lyme actually don't show up until this has had the opportunity to build numbers and have an army. And often that happens after some kind of drama shows up and say, oh, three or four years ago I had this. But after the loss of a love and all of a sudden they show up with Lyme symptoms and you think you're never getting an IGM on those patients and sometimes you get IGTs and in your case you're not getting the test that shows positive. So then the question is the symptoms that I usually will see. First, I've seen 10 doctors, patients will speak this to me. I've seen eight or 10 different doctors and no one can tell me what I usually will see. And so the diagnosis of exclusion is a big one. Amplified Muscular Pain Syndrome, Fibromyalgia, Chronic Fatigue, these kind of things without causative effect or with no medical diagnostic capability to actually determine there's a disorder would say, hey, you've got these symptoms. That is a very good place to look for Lyme, classic symptoms, transient joint pain, of course. People say, oh, my knee hurts for a week and my shoulder hurts for a week and there's no rhyme or reason, random pains like that. But neurologic symptoms are very strange. I had an alpha-gal syndrome patient. She came in and she was all of a sudden allergic to red meat, alpha-gal syndrome being from the Lone Star tick. People have to develop a meat allergy at meat. So you get very random symptoms. What's the term for food? Basically become allergic to all foods. It's almost like an EOE and eosinophilic esophagitis response where all of a sudden people are having panic and anxiety after they eat. Just very strange symptoms. And of course, their physicians are saying, here's some Prozac. Yeah, it makes sense. And one thing that clues me in on is the data really shows there's very, very few in the differential of migratory neuropathies or migratory joint pain. So if you have joint pain that won Tuesdays on your elbow and Fridays on your knee and then migrates around, there are very, very few things besides Lyme disease that cause the migratory arthritis. If you just have an RA or rheumatoid arthritis and it's always your fingers when you wake up at the morning for 10 years, that's pretty classical. And a lot of the rheumatological diseases stay with one area of the body and just progressively get worse. But if you're having those migratory strange pains for unusual, where you have numbness or tingling one day in the hand, other day in the feet, brain fog and brain dysfunction are super common with Lyme and mold. So that's an incredibly common thing with the brain and nervous system. Like you said, anxiety, sleep disorders, depression, all super common. And then so I think a pain and fatigue as the number one and number two, unexplained pain, unexplained fatigue. Would you agree? Is there anything else that's like a big key that you're like, oh yeah, that's very likely in that realm? Of course, mysterious things. No, that's really big. And actually goes back to the beginning of Lyme disease awareness, right? 1970 in Lyme, Connecticut, a rather large epidemic of children being diagnosed with juvenile rheumatoid arthritis. And two people who said there's no way this is happening. They went to Yale, right? And they had a number of researchers from Yale come and do some information or do some studies. And they found they isolated in children with the bullseye rash, right? The first spirochete isolated from the skin, from the blood and from the spinal fluid, right? So started out as a rheumatologic condition that way. And of course, that's an immune response, right? Doing exactly what it's designed to do, which is what's so tricky about this is you're, you're treating a healthy immune system doing what innately it was designed to do, right? Exactly. So let's talk just a little bit about that. So if our listeners aren't super aware of basically what Dr. Shaw is talking about is when we have some trigger to the immune system. And in autoimmunity, there's always a genetic predisposition towards this overreaction of the immune system. And then there's some environmental trigger, and then there's always a gut immune barrier dysfunction. So with that environmental trigger, it could be heavy metals, it could be environmental toxicants, but many, many times it's an infection. So you could get a mono and Epstein bar, and then it triggers this chronic viral issue. You could get reactivation of varicella, which is chickenpox and gets shingles. Or you could get bit by a spider or tick or arachnoid or mosquito and get an infectious disease that's in this realm. Now the classical Lyme is just one tick, one strain, that kind of thing. Well, there's a lot of those in that, in that Lyme Borrelia, but there's so many more that we're talking about here. And that's why it's not always a bullseye rash. It's not always a simple tick. It can be these other things because they carry, it's like nature's dirty needles I've heard. And I love that analogy because they're full of infections and studies show the average patient who has Lyme disease has two, three, four other infections. They can be Bartonella, which really affects the nervous system. It often causes anxiety, neuropathies, seizures, very severe issues, sometimes pan and pandas with the auto-immune encephalopathy of the children. And then Babesia, which is a malaria type illness, it affects the blood. These affects the blood cells. And so that will cause night sweats and air hunger and anxiety and insomnia, disequilibrium, those kinds of things. And then there's Anaplasma, ehrlichia. And don't you see just a slew of these all together in patients? And those are the co-infections, right? And those sit beside the patients who also have mold in their home. Yeah, let's talk about mold. How does that fit into this? And how do you, how do you figure out like which comes first? What's your order of operations if you have someone with suspicion of both? Yeah, I mean, so to determine whether moldy or Lyme, right, there's all the different diagnostic tests that we run through the gamut of blood work. And of course, urine profiles that can tell us if they're spilling mold toxins or not. I guess the idea whenever you're managing a Lyme, I almost feel like we coexist with Lyme rather comfortably. Like I just have a vibe, almost like mono. You had mono. You might have been down for a couple of days. You weren't aware that it was mono. It just hangs out in their dormant. And then whenever your immune system takes a hit, this has an opportunity. It's like, oh, the coast is clear, right? It comes back out and it does this thing. So I spend a good bit of time educating the patients about what's actually happening. I think part of it's people coming for treatment. And the other part is people are really coming for an education because you have to know your enemy, right? But understanding what is more likely to suppress the immune system for the number of mold and Lyme patients. I'll say, hey, go to your house, do a rather thorough inspection. You can get air testing done and see if there's mold scores there. It's strange. We'll treat a number of patients for mold first and then consider maybe, I can put it on their treatment plan. Maybe we'll do Lyme second. When their immune system comes back online, they're asymptomatic. And I say, why even go after the Lyme? I just don't even think it's, if your immune system is robust, I think you just get past it personally, right? And some patients... This is why I love talking to you because you're one of the few people we totally agree on that. I've often told people, you know, mold, again, they're walking along. I say this all the time to patients. I think there's tens of thousands of people walking around with Lyme disease. They don't know they have it. They don't have any symptoms. They don't need to be treated. It's no big deal because in a real healthy environment, our immune systems are designed to take invaders to have old infections to keep them at bay. I mean, we all have tons of old viruses and old infections that are lying dormant in our system, but then we get surgery. We get trauma. We get lack of sleep. We get stresses in the job. We get in a moldy house and something takes us over the edge. So then all of a sudden, I would say it's like a limbo bar that dropped and then these old, you know, infections pop up like Dr. Conan said and basically take over, start to cause symptoms. So usually when someone's presenting to our office, as you mentioned, I'm asking them about the house, about the environment, about the stresses, about the trauma because usually, I'd say about 50% of the time, something triggered immune deficiency, immune issues where they're not robust enough to take care of the infection. And when you get that back online, that really takes care of things. And even the mold affects detox. So I've seen people who look like they have massive heavy metals and toxicities. And when you get that detox system back online, because mold tends to trash the glutathione status and really, really break that system down. So when you get that back online, sometimes they don't even need as much detox as you would think either. Right. Yeah. It's absolutely true. And I think you and I will call it the total toxic burden, right? I mean, you know, I actually try to make a list of the bad guys and say, okay, well, we're dealing with Lyme obviously, right? And so let's see what else is in there. And that's why I'm not a really big protocol guy. A lot of people will call the office and say, Hey, what protocol do you use for Lyme? And I said, there's really no protocol for Lyme. There's a strategy for Lyme, right? Strategies gets your immune system smarter, stronger and faster than the bacteria, pull the bacteria out of where they're hiding, right? Because I believe that there's 23 ways that the Lyme can hide from the immune system that I'm aware of. And so, you know, you really need to get your immune system back in the proper space to be able to manage that. But there's no protocol for that specifically. There's a few underlying tones that kind of continue to resurface with people. But how many patients are very similar to my story? I went to eight years ago, I went to MedExpress, very, very ill, which is not like me. And I don't usually get sick. When I get sick, I'm not worried about it. When I got extremely ill, I said, I'm gonna still get a medical opinion, make sure I'm okay. And the doctor has said, that's just a virus, just go rest. And I did, it was three years later after I had a loss, an emotional loss, that all of a sudden there was transient joint pain and there was neuropathy and there was panic and there was depression and there was all of these things. Wow. Never would have tracked it to that tick by three or four years before, right? And so, the question that I've asked and I know you and I've talked about in the past is, if emotional trauma can suppress immune system, why is it addressing emotional trauma, part of a core treatment plan for chronic Lyme patients, right? Yeah. Yeah, I love that you bring that up. And I love that we're talking about that publicly because whether it's acute death, a loss of a loved one, surgical procedure, or just, I mean, even this pandemic has happened to many people, if they've lost a job or it can be, you know, job loss or divorce or child in trouble or not doing well in school or even death of a family member or friend, all of these things are very traumatic and those do suppress immunity. We know things like increased sugar intake, loss or trauma, all of these things massively affect the immune system. Even isolation, which people have heard me say this here before, but that was one thing in the pandemic I was struggling with because they were not taking into account the massive effect on immunity that social isolation actually has. And I really think that we were missing the boat. Not that we did everything wrong, but that we didn't take that into account as part of the equation because childhood trauma and isolation and loneliness, they are maybe some of the biggest players in immune dysfunction. And why are we not having that discussion? It's so powerful. And that's, you know, that's a pretty easy line of questioning to ask people, give me a number from here to 10. Where's your stress level? I mean, let me ask you this, how many of your Lyme and mold-borne biotoxin patients you're working with, do you have on some form of adrenal support at the same time? Yeah, probably 90%. Right. So, that underlying component of stress, over stress, it breaks the bank. It's one of the things in the total toxic burden, and I think the spirit, excuse me, the spirit of the mind and the body being connected, that's part of the dialogue and really communicating with people and saying, hey, let's focus on positive mental attitude and doing things that bring you good feelings and whether it's counseling or yoga or meditation or prayer, whatever it is, I get part of the treatment plan, right, because it's, you know, pulling people out of that. It's not just a bacteria. It's more than that. I agree. And again, you and I have dealt with both Lyme and mold personally and some of these things. But one interesting thing that we've talked about too that I think people would bear hearing is we've both done NLP and we've done somatic work and we've done some of the deep work. I will tell you, Dr. Shaw, I'm happy to say this publicly, some of the transformative NLP somatic based trauma therapy, thought field therapy and EMDR, brain spotting, I've done all these things. And I realized with my mold related illness and recovery, some of those treatments and things that dealt with old past traumas that were stuck in my body and system were really affecting my immune system and my ability to fight infections and my ability to show up in a healthy way. And it was, I would say that was equally important to any herbs or protocols or detox that I did. So if you're stuck and you have Lyme or mold related illness and you have not even thought about dealing with old trauma, I highly recommend. There's all kinds of things. Like I mentioned, I'll just repeat them. But DNRS is an online program that Annie Hopper and Dr. Gupta both do that's very effective. You can do it on your own. Both Dr. Shaw and I have done neurolinguistic programming or NLP and some of that somatic work and highly effective, wouldn't you agree, with some of those triggers and things. And then I've done in the past other types of somatic based trauma therapy. What that is is just there's cognitive behavioral therapy where you sit and talk to someone and you talk about your thought processes and you talk about why you think that way. But if you're analytical, like Dr. Shaw and I, we don't need more analytical stuff. That's where we get stuck. We get stuck in our heads. It doesn't do any good for those of us who are analytical because we've already written down, we've journaled, we've made the plan, we've thought about it, we've tried to figure it out, we can't get past it. What we're talking about is in the cellular tissues of the body where trauma is stored subconsciously, how do you get there and get to that level and start to feel and actually feel like you don't talk about it. You say, oh, my heart hurts. And then what does that lead to and where's the memories and you deal with those things. So I won't go into all the detail. I just want to be sure and say that if you're stuck, that's a great place to start when you agree. Yeah. And I love that you're, I love that yours kind of validating of the therapy as you are because not to sound page three YouTube about it, right. You get down six or seven pages in YouTube and you see some guy and he's like, if you want to heal Lyme disease, take my Lyme vitamin. Yeah. Right. And they just sound like you're like, who's this person who's just saying, like, you know, forgive everyone. And you're like, what? Because clinically speaking, this is all validated. Yes. Neurocytia immunology, right? The spirit affecting the mind affecting physiology and either you heal faster. If you bring peace to your spirit, or you fight a little bit harder, right? You start, you're still going to help people, but you heal faster. If you say, Hey, there were some trauma in my childhood, someone helped you to release that trauma. Cause it's just all back. It's all a bag of mucky buck, right? It's all bad. I love it. And I always like to clarify trauma because a lot of you listening, you're like, Oh my gosh, I had a great childhood. I had great parents. I said that. I know to just Shaw said that. But what happens is when you're too, when your sister gets ice cream and you don't, or when your father said something that stuck in your head and you thought it as a recording that wasn't true, those kinds of things can actually affect your health. And they're not a big deal. But when you don't have the resources at five or seven or 10, they are a big deal. Because at that time you didn't have the resources that you do now as an adult and your little child is still struggling to deal with that thing because they didn't have the ability or the resources to understand at that moment. So these are not, I mean, yes, I acknowledge some people have been through horrendous trauma. That's a whole another ball game. And I have such compassion for those people. And probably some of you listening would be like, Yeah, that's me. And I'm so sorry if that's you. But some of these things seem like they're insignificant. And even if you've had a great family, great childhood, they are important to address and deal with. Let's get practical because people always love not that we're going to make recommendations for treatment, but what are some of the like really broad spectrum just like nutrients that we would say for like detox. And then what approach do you go with herbs? Typically first you do medication like you recommend medications first from a physician or how do you do the protocol with say someone comes in with Lyman mold, and clearly they're in a moldy house, they have Lyme disease. What are basic nutrients that you would give them? I love that. So like you, I would start food first, right? And I would always say, if you don't lock the inflammation in your body down with your diet, it's going to be a bit of a struggle. So that makes me somewhat unpopular with certain people who won't come to see me because they know that I'm this like diet warrior. I don't suggest that people go on the keto diet, although the keto is the lowest inflammation kind of diet that's going on, I guess. But I definitely have people go towards an anti inflammatory diet to start just to lay down the ability for the body to be in this space where it can heal, right? And then we start going into the nutrients and we always have some usually there's a, okay, I'm sorry, let me back up. If it's mold obviously is you're especially you get people out of the mold, right? So you make that that's clear. And then you say, let's start opening up the detox detox pathways. I'm a big fan of genetic testing, right? The single nucleotide polymorphism testing and kind of learning where people's weaknesses are on the genetic level, because it gives me like a little cheat sheet of where they're weakest that kind of helps me support them. But glutathione is usually a nice place to open up detox pathways, primary detox is liver, of course, secondary is colon, they're both extremely important for the body's ability to remove toxin. Remember that sometimes toxins clear the liver, but when the gut is unbalanced, you resolve the toxins, right? So that's post-epatic and terrapid absorption of toxicity. That happens with estrogens as well. And so I'm always liver gut first, right? I always kind of go into that phase. So the diet is there. Hydration is usually 50% of the patient's body weight analysis. We tie trade up to that slowly. We don't try to just like force water, but half the time when I'm seeing the patient, I've got my pom poms out and I'm cheering for them to stick with their diet, right? Because I really, really want them to heal. And then, you know, as you would kind of go into anesthetal cysteine and psylliumrin and milk thistle and choline and then acetyl and those things just to support general detox pathways, that's a start, right? If it's a mold patient, I know you would have a whole protocol of binders, right, or different things that you would use. So am I answering the question the way you would answer it? Yeah, I just want like basic nutrients. So glutathione, NAC and nostril, I totally agree on all that. PC, real powerful for cell membrane. So that's healing there. And really a limer mold, those are kind of core. I think with limes sometimes resveratrol and sulforaphane can be effective, just helping those pathways. There's a recent study, I think it was out of John Hopkins that did herbal treatments for Lyme and vitro. It's one of the more recent ones. And it was interesting because many of them didn't do a whole lot in vitro, but the two that outperformed everything was cryptolepis and resveratrol, so Japanese knotweed. So because of that study, I've actually tended to go a little away from some of the old formulas I used to use. And I use Japanese knotweed and cryptolepis. And I find Japanese knotweed has some anti-inflammatory activity. It's really powerful, but it's also very gentle. People don't tend to have Perk's reactions as much. Cryptolepis is a powerhouse. You better be careful with that one, because it really has some spectrum, I think activity against babesia and Lyme. And do you use those herbs, any herbs in specific that you like? I definitely do. And a couple of fun facts on resveratrol, because people always talk about their wine and they're drinking their wine. And I did a Facebook post on this about two months ago, you need to drink 18 bottles of wine to get what you get in one capsule of 3.75 milliliters of resveratrol. So don't fool yourself with the wine. But the idea there is, is in Western Pennsylvania, where Lyme is, is epidemic, right? Japanese knotweed is overgrowing. And they always talk about how nature has, how nature has a cure. It's very, very powerful. But I use Japanese knotweed across the board with Lyme patients. I don't usually enter in that with multiple patients, but with Lyme, I do use. There's usually an essential fat. I eat awesome things in for collagen support, because Lyme is kind of like the bacteria that gobbles up collagen, right? And it causes very cascade. So I'm educating patients on that. And there's usually an essential fat. Perfect, yeah. Carcumin would be a good source. Just general support for inflammation for some patients is beneficial. Helps them feel well. Yeah, exactly. Most of them do have pretty significant inflammation and pain. So yeah, I love curcumin. Now I do find there's a small percentage, I just say, and I'd love to know your snip, a few of your snips maybe that you see commonly. So we'll talk about that in a second, but it just made me think just a couple of unique things. Curcumin with people with histamine issues can be an issue. It's not common, but there are small percentage that don't tolerate it. So a lot of these things like bone broth, you think amazing. Everybody should be on bone broth, but not those with histamine issues. Curcumin, anti-cancer, anti-inflammatory, it has so many studies. Love it. But if you have a massive histamine issue, you may not tolerate it. So these are just little pearls. And then bas-wellia is an alternative. If you can't do curcumin, I love bas-wellia, frankincense is another name for that. And then corsetin, love corsetin. It's anti, it's massive stabilizing anti-histamine. But if you have COMT++, corsetin can be inhibitory. And what that can do is cause buildup of neurotransmitters that are excitatory, causing anxiety or estrogens. So I just personally, I have the COMT++, of course, all of those of us who are driven in Taipei. I think we have that, Jean. Do you have that one too? I'm a single step of COMT. Okay, cool. Cool, cool. What I was going to say though, I noticed just personally, when I took too much corsetin, I would get breast tenderness, which is that estrogen dominance. So I always know if I overdo the corsetin, I'll get the breast tenderness. And that's a sign for me that I have to back up so that my estrogens can metabolize normally. So you mentioned genetics. Is the genetic test something that must be gotten through a physician? Is it something patients could do and what labs do you like for that? Oh, that's a great question. So some people find it to be a little bit controversial. 23 and me, right? So for under $200, I get 17 of the relevant clinical SNPs in the methylation pathway. There's a question. Ancestry.com would also do that. Some people don't like these gene reporting sites because there's a question about sharing data and maybe the government would know what you're predisposed to or something. So I think for the amount of money you spend for those SNPs, I mean, thousands and thousands of dollars. So for under $200 to get a 23 and me and get the raw data downloaded, we actually don't use any information from 23 and me. I use Ben Lynch's company. I use strategy data through that. You order 23 and me, get yourself, you spit into a tube, you set it in. About three weeks, you get a bunch of information. We take that information in about two minutes and turn it into a strategy report. The strategy report, I can kind of give you the vibe. That's what you're looking at. You get your positive. Is that visible for you? Yeah, we can totally see that. Yeah. And so the new people would want to see this and say, well, because they can do that on their own, all of that. Now, of course, you might need a physician to help you interpret, but I love this because you're exactly, I totally agree 23 and me, there is controversy. It's the easiest, cheapest way. I did a new Amsterdam Genoma complete gene analysis, $3,000. And it was cool. I'll tell you, I mean, granted, it was very, very cool, complete DNA, not just SNPs. However, that's way out of the field for most people to afford. And I just wanted to know what the company was. I don't usually recommend that. So we can do this for $200. And then there's also genetic genie, which is very much smaller, but it's free. So if someone is really strapped or whatever, they can get a very basic report that's decent with a few of the, like MTHFR and CUMT and NOS and SOD with that. And then I love the strategy as well. Bob Miller has a program that I don't use, but a lot of docs use that and it's excellent as well. And so there's quite a few out there. But I love that you're talking genetics, because for me as well, it's kind of this foundation that I don't always go through, that would take maybe a two hour visit to go through just the genes. But what I do is I reference it like you do, so that if I'm giving them Corsitin and they have COM2 mutations, then I'm just aware that I don't want to overdo that pathway or methylation, I make sure that I give them the right form of bees, which we're normally doing anyway. Right. Does say someone has a double heterozygous or two of C677T of the MTHFR, which is one of the more popular methylation genes, would that change your treatment with limer mold? Would you do anything slightly differently if they had methylation issues? It would. I would give some methyl donors in that. So when you have either compound heterozygous, one of each the 1298C and one of the C677T or your double or your homozygous for the C677T, you're 60% to 70% less effective in methylation. So we're talking about moving things in your body and your cells. That's methylation really is what moving things around. And it's of the five detoxification pathways, one of the more powerful ones. When you have that double SNP, you know those aren't always turned on. So I always remind people, this is not your destiny, but it's where your weakest link is. Well, you know limer mold or a really nasty relapse of mono or any of these co-infections would turn these on. So I can kind of go into those genetic SNPs and say, yeah, this is turned on. And so I'm going to do more support for that methylation pathway if it's slowed down. So I would give a TMG or a B-tain, right? Or I would give the right kind of methylated B-vitamin for the individual. But also remembering that that's at the top of the chain. I love going downstream and having the other SNPs because if you've got a double GSTP SNP, remember, lime disease as a bacteria is giving an endotoxin, that endotoxin, not being able to be detoxified properly. So if I've got a double GSTP SNP with an MTHFR, this person can't get the stuff out of their body. Right? Remember, you are what you eat, breathe, touch, taste, smell, but most importantly, what you can't eliminate. That will change my treatment plan immediately. How am I going to get this patient just eliminated with toxin? Because there's your Herxheimer. I know we didn't talk about Herxing, but the reaction to killing bacteria and winning the war sometimes makes people feel worse, right? So while you're getting better, what you're sick from is not detoxifying fast enough. So those methylation SNPs just give me that edge and that knowledge and that insight to say, hey, maybe I can help them feel better while they're beating this monster back. Yeah, I love that you bring that up because patients who are listening, who have had this, they understand this very well. And I always describe it as this. It's mobilizing toxins and eliminating toxins. And we can mobilize pretty easily. Those are actually, I think that's the easiest thing to do in the world. And if we mobilize too fast and we're not eliminating properly, then we get stuck and we get this accumulation. So for example, and I kind of in my head, just from experience, and I'd love to hear your opinion on these things, I categorize things into safe. You can't really overdo the mobilization. Like for example, epsom salt baths, unless you have an allergy to sulfate or something like that. Usually people tolerate that and they can do them every day without getting sick. Usually, let's see, other things that dry brushing also super safe, hydration super safe. Most of the homeopathic drainage remedies super safe. So those kinds of things are generally you can mobilize and excrete pretty equally. But what I find is things like antibiotics or anti lime herbal treatments, or the detox stuff with mold, if we push glutathione or NAC or these two fast with binders even, those things can push too hard. And sauna and for sauna amazing, but I feel like people can push that too hard too. So in my mind, I'm always trying to weigh these options and saying, are we mobilizing too much? And many doctors are like, oh, you're going to have a Herxhem reaction. You're going to be in bed for five days. I'm like, wait a second, don't like that at all, because a Herx is actually this complete, you know, inability to excrete. So it's a bad state. You don't want to keep people there. You don't want people to be there if you can avoid it. And I don't know about you, but sometimes it's inevitable. But I'm always trying to at least eliminate or decrease the amount of suffering that's potentially there because that means we're pushing too hard. You're nice like that. I don't want you to get too sick. I often will have a Herx protocol for people. They increase your liver support, increase your colon support, increase your patient, take it up some salts bath and stop your pregnancy that back. You know, your biofilm paupers all, you know, do those different types of things. So Perfect. Yeah, I have a whole sheet of this too. It's like, because a lot of it's bowel elimination. Like you said, it's enterohibatic recirculation. If you're not eliminating through the stool, you're screwed. Not really, but that's one of the things I learned in Switzerland. Three things from there that we don't typically do. You probably do this better than I as an allopathic MD, but we were never trained. And this is colonics, hydrotherapy, colon hydrotherapy. Weekly in a really significant case can be powerful. It helps with that elimination. I don't routinely recommend that, but in Switzerland during the detox, everybody got a weekly colonic. And that actually was a big aid, coffee enemas, another really big thing that can be done daily in the severe cases that can really amp up the glutathound production by about 600%. So that can really save people if they're stuck in this detox thing. And then bitters. I'm a huge fan of bitters, and we don't hear a lot about that. Do you use bitters much in clinical practice? I really don't. I don't, but I know that most of the getting your gallbladder clearing, it's definitely beneficial in and out. Yeah, and none of it really tolerates it. What I find is the bitters, if the gallbladder is excreting bile, bile causes sterilization of the small bowel. So you get a lot less of the small bacterial overgrowth, small intestinal fungal overgrowth, parasitic infections. And then the bile is where the toxins are stored. So if you're pushing that out, you tend to get a better detox as well. Yeah. Cool. Well, any last words of wisdom as far as just things that patients might not know that if they knew that this would be an easier course, any last bits of information that would be helpful? Yeah. I mean, I think the more you remind yourself or educate yourself on a process, I like to go big picture a lot of times instead of a lot of the molecular things that we're talking about. I really like to be reminded you've got like a trillion good guys, and there's like a million or a billion bad guys, and you're going to win, right? And it's about numbers. And you got to kill enough bacteria to the point where the other army starts to retreat, right? And you're going to get there. And the only way to fail at that is to quit, right? Or to stop looking for answers. And when you hit a wall, I know you do the same thing when you hit a wall, you think, ah, mastile activation, you think histamine intolerance, you think the gut, you think, what am I missing? Let's do some other testing. Let's take a break. Some people weave. I'm just reminding people it's Lyme is a strategy, and it's constantly changing. My Lyme protocols with my patients are changing every month. Diet can change, right? And so the idea is the big picture. It's if it were a bacteria that was going to kill you, like meningitis, you'd already be dead. Yeah. It's not about that. It's the problem is that after some of these individuals have been suffering for 10 to 15 years, and then they come in and you diagnose them with Lyme, and they're relieved to have an answer. But then here's the eight to nine month battle that you've got to fight, and you might get a little worse, and you matriculate towards having good days. Half of what I do with Lyme patients is cheerleading. It's just reminding them it's going to be okay. It's okay not to be okay. It's okay to have bad days, hang in there and kind of keep believing in where you're headed. Because, you know, a lot of it is trusting and healing and trusting in the human and the native intelligence to do what it's designed to do. And that's our job. Our job is to interpret that, right? The blood work and the patient's response to what we're doing. It's tricky. But, you know, the best last tip I can say is don't give up because I went from sleeping 30 minutes a night, three weeks straight and going neuropsychiatric. And basically, being at the point of not knowing if I was going to be alive to completely functional with no symptoms, it took a lot of climb out. But once I got a diagnosis of Lyme, I could climb out. And just I had to dig in and do it. Yeah, because I love that because people who are suffering, if you're listening and you've had this and you've dealt with it for years, there is hope. And both Dr. Shaw and I have personal experience. And we're standing here saying, you know, we have full functioning practices. We're busy. We have lives I can go hike and ski in the winter and do what I love to do. And I used to be, I'll tell you a real quick glass story here 10 years ago when I was moving to Colorado to start my practice, I was in the midst of unknown, unbeknownst to me, mole exposure and active Lyme disease, didn't know it. But I had such severe back pain. I have a real high pain tolerance, but I remember like passing out cold because of the pain one day. And then that flight home back to Illinois where I was transitioning to move, I literally needed a wheelchair in the airport. And I'm not that type of person to even ask for help. But if my pain was so bad, I could not even walk onto the plane. I've never been so, that was 10 years ago. So the truth is, and now I hike and I ski and I don't have pain. And it's funny, Dr. Shaw, my orthopedic doctor looked at my MRI of my spine. He said, Jill, you have severe degeneration L4, L5, L5, S1. Like they were saying, you need surgery or you need PRP or some sort of stem cells, you need treatment. This is really, really, I mean, it's bad on the MRI. Guess what? I have no pain. I can do anything I want. I mean, I know how to properly lift to protect myself, but I don't have symptoms. There's nothing I feel like I can't do except maybe a 200 pound deadlift, you know, but realistically, I don't have limitations and yet I have what looks like a severe issue from the Lyme and from those inflammation. And so don't be discouraged if you've been told there's no hope or told that your pain is chronic or told that you're going to have autoimmune disease forever. That's just not true. So seek out someone like Dr. Shaw or myself to help you. And I'll be sure and link to his page. Where can people find you for more information, Dr. Shaw? If you link to my Facebook page, I usually put information up two or three times a week on there at website, www.drcshaw.com. So I put some blogs on there. I'm not as prolifical writer as Dr. Jill is. You write quite frequently. So I have information up there for people in the book. They can certainly go Facebook or to my website. Good. We'll be sure and link up with that. And you're still taking new patients, right? So if you are out on the East Coast, actually anywhere, do you do zoom in a virtual now as well? So pretty much anywhere in the, so if you have a complex issue and you need someone, Dr. Shaw is accepting patients. Well, thank you so much for your time today. It was so fun as always talking to you and have a great afternoon. Thanks so much, Dr. You're welcome. Take care.