 Hey, everybody. Happy Memorial Day weekend. I am delighted to be here with you for another Facebook Live Q&A. If you'll bear with me, I'm just going to get so that I can see your comments and questions real quick here, and then we will jump right in to the topics at hand. I know some of you are joining us from the local Colorado Lyme group that I spoke at last Saturday. And so if you have your questions, you are more than welcome to join me here and ask away. I look forward to that. And give me just a second. I want to be sure and see your news feed as I'm going here. So I'm just getting set up for that so that I can actually see your comments and questions and everything here. OK, so good. OK, so I can see your comments and questions and anything you want to bring here. So say hello. Tell me where you're from if you're listening live. If you're local, tell me if you're from the Lyme summit that was recently last Saturday held. I think we had Dr. Poroscano, myself. I can't remember who the other speakers were, but look forward to talking to you. And hi, Radha. Great to have you here. Please say hello. Tell us where you're from. Just a little housekeeping, and then we'll just jump in. I will probably just jump into some more random topic and then I'll watch for some questions. Maybe we'll start with some Lyme disease topics since I know I have some listeners. And hi from Houston, Radha. Hi, Cindy from Pennsylvania. Yeah, keep jumping in there. Tell us where you're from and say hello. So first, just a little housekeeping. If you don't follow me on Instagram, you're missing out. I show all the candid shots. I was just in LA last weekend for a photo shoot of all things getting ready for next year. We're going to launch a documentary and a book all about environmental toxicity, mold related illness, Lyme disease. So stay tuned because you can follow me there for candid photos and different things about what's happening. And what I really try to do on Instagram, it's just Dr. Jill Carnahan. Go there and hit follow. You're going to see little memes of some of the articles I do. And I don't know about you, but I actually love how the Instagram, you can make this simple little photo of a recipe. And it's kind of like with one shot, you can see what the whole article is about. And most of us anymore, we have a harder time of reading the whole article or sitting down for a whole book, sadly, but if you enjoy those memes, I've got lots of them there for you. You can go to JillCarnahan.com for free content. We've got all the videos and blogs and articles that I've ever done are almost all on the website there. So you can find recipes, you can find blogs. I put out weekly content ideas. Hi, Donna. Hi, Danielle. Thank you, Radha, for your congratulations. And so there's tons of free content there. And if you're not part of my free newsletter, I'll put a link in the comments after I'm done, but feel free to join the newsletter. You'll get all kinds of free content there too. And I don't come here to mention products, but if we do talk about someone asking about products or what to use for this or that, you can find all of those at drjilhealth.com. So those are the main places where you can find me. And thank you, Cindy. So please feel free to type in your questions. You're live with Dr. Jill. And I am here just to answer any questions that you might have. I can see the feed. So I will jump right into that as you guys start scrolling down the questions. Usually it starts a little slow and then towards the end, it's just questions that I can't even get to all of them. But let's start just a little bit with Lyme disease. You know, recently there's a celebrity who came out, Ryan Sutter with his diagnosis on all the major news outlets this week and his diagnosis of Lyme disease and mold toxicity. I encourage you if you haven't read any of those articles or seen Trista Sutter's podcast called better, et cetera. Check that out. You'll hear his story. And I think it'll resonate with a lot of you out there and with your journeys. If you've had Lyme disease or mold toxicity, what I see more and more is in functional medicine, this toxic load and infectious burden are such a problem with so many of our patients. And it's only getting worse because of our environmental toxic burden because more buildings being airtight and some of the toxic molds that are growing indoors. And so many of you, I know, understand this and have suffered. If you have any questions about either one of those, please feel free to ask and I'll do my very best to answer. If you read the Lyme summit, I talked about kind of an overview of some of the infectious and toxic things and how they relate to one another. One thing in particular, a lot of people think of endemic areas and they're, you know, the East Coast, Connecticut, Rhode Island, Vermont, Wisconsin, Michigan, a little bit into Illinois, Florida, California on the coast. But what we're seeing is really all of the United States are having more incidences of tick-borne infections. And part of that is because there, you know, other types of infections besides just plain old Borrelia. One in particular is called tick-borne relapsing fever, TBRF for short. And our typical Western blot on LabCorp or Quest or most of those labs doesn't test for tick-borne relapsing fever. So I find a lot of patients can present, especially out here in the mid, in the West. So Colorado, Utah, even down to Texas where this is more common. They'll present with a tick-like infection. So they may have joint pain and fatigue and symptoms that came on after a bite or after exposure to horses or dogs or someone that was had a lot of, some animal that had a lot of ticks on it. And they will have tick-borne relapsing fever. And right now I recommend Digenix as a lab because they're the only ones really testing for the subclasses and the species of tick-borne relapsing fever. And I've seen a lot more of that, especially since I see patients in Colorado. So that's an interesting thing. And you will not see that positive if you do a typical Western blot from any of the conventional labs. So tick-borne infections, super common. What I find is often in a molding environment, the mold will weaken the immune system and old infections like viral infections, cold sores, or herpes viruses. Chickenpox will pop up as shingles or tick-borne infections like Borrelia, Babesia, Bartonella, Ehrlichia, Anaplasma, they will pop up and start to affect that patient's health because of the weakened immune system. So these two definitely go hand in hand. So I'm seeing some questions. Hi, Connie. What's your recommendation for long COVID? 21-year-old inflammation in hands, fingers, knees, PMF, or something else. So the neat thing about long COVID, if there's any neat thing, that's a terrible way to start, right? Because it's not a neat thing. But the mechanism of what happens here is not new to functional medicine. So this just happens to be a very inflammatory virus that triggers immune inflammation and cytokine response. But we've seen this for the past 10 to 20 years in functional medicine. We've seen it with Epstein-Barr. We've seen it with Coxsackie virus. We've seen it with CMB. We've seen it with herpes viruses, cellulose, and all kinds of viruses, and even other infections where they trigger this inflammatory immune response of cytokines. And that becomes somewhat activated. So these patients are chronically inflamed. And the key there is decreasing the cytokine inflammation. So the first thing I would do is support with anti, with nutrients that would support the system, the immune system. Some nutrients that are key in being supportive to the immune system would be vitamin C, zinc, vitamin D. And acetylcystine, glutathione, and a B vitamin. Those would be all core. The other things that you'd want to do are support the inflammatory cytokine response. The things that could be supportive here would be like turmeric, Boswellia, Corsitin. I also really like Chinese skull cap. We have a couple of products. One called Cytoblox, C-Y-T-O-B-L-O-X, that I really like for that cytokine inflammation. And that dose is about two, twice a day, depending on the person and age. Super helpful for inflammation. And then anything with turmeric, like super turmeric, is fantastic. It's a full curcuminoid oil base. Really like that product, super turmeric. And anything with Boswellia. I'm a huge fan of Boswellia, resveratrol, Corsitin. So we have histocystis, which has Corsitin and bromelain in it. We have plain Boswellia. We have Dr. H-Re-Joint, which is a combination of products for joint pain and inflammation. So any of these kinds of things can be helpful. And then I typically would have them do a very anti-inflammatory diet, free of gluten, of dairy, of sugar at that very least, because you don't want to add that inflammation. It's not that the foods are causing the issue, but you want to just take away that burden in case gluten does contribute to the inflammation in the body. Plenty of sleep is really critical. Sleep is when we recharge and our livers have the chance to detoxify. And our immune systems have a chance to restore. So essential seven to eight hours of good quality sleep is absolutely key. Sleep is one of those things that I start with with patients, because if that's not working, nothing else is working. The healing can't happen. So sleep is really essential. So those are just some of the things that I would do in supporting the long haulers. Very similar to other infections. Hi, Don. Do you have any resources for severe diverticulosis? So diverticulosis is outpouching in the lumen of the gut. So usually in the colon where there's little tiny pouches that have been by pressure. So your gut lumens say it's supposed to be kind of a flat surface. It's almost like if there were seeds and nuts and things and causing this outpouching. And so these pockets can get debris that coalesces in there. And then there's infection because that doesn't move. So whenever anything like that is stagnant, then it can get stuck seeds or nuts or bacterial remnants or things or stool. And then that becomes inflamed because it's stuck there and it's not moving through the colon. So first thing is diverticulosis is just the pockets that exist in the colon if someone has this. But diverticulitis is inflammation or infection in those pockets. So if you just have diverticulosis, it can be hard to completely reverse that. But the ways I would start our healthy fiber anti-inflammatory diet, I would probably recommend a low glycemic, maybe minimal grain, at least gluten-free, sugar-free, dairy-free, probably corn, soy, alcohol, sugar, all of those out, maybe egg, maybe peanut. Those are all kind of the common inflammatory foods. And to eat a real diet that's low in inflammation, I would make sure there's probiotics on board, like spore probiotics. I like mega spore. I like HU58. Some of these really great probiotics are helpful. And then making sure that you have a low inflammation and that you're treating any bacterial dysbiosis. Bacterial dysbiosis could be treated by a daily berberine. Berberine's also good metabolically, but it tends to have an antimicrobial effect. But you could use something else like grapefruit seed extract or garlic or something else. And I would probably do a stool test and an organic acid test to determine if there's any dysbiosis that needs to be treated because that will probably be an inflammatory trigger for someone to develop diverticulitis. Now if someone's in acute diverticulitis, which is that inflammation of those little pockets in the colon, antibiotics are very appropriate because this can be very, very, cause a lot of illness. It could even cause a rupture of the colon. So the typical antibiotics that are used are ciprofloxin and metronidazole. Those are heavy hitters. So I don't go to those easily. Like I may try berberine if the patient's not septic and they're stable and they're just minimally inflamed, but typically antibiotics are needed in the acute phase because it can be very, very serious. So that'd be something you need to talk to your doctor about. You'd want to, you know, this is not medical advice. You want to get your doctor's advice and treat that or go to the emergency room if that's happening. Okay, let's see what else. We got some more questions coming in. Hi Carol, do we get gastroenterologists to become, oh, how do we get them to become educated? Three major groups with dozens of doctors and everyone is clueless to MCAS, so they're called the psychocytic enterocolitis and they don't have time to get elevated. Severe attacks put on bedesonite. I can't tolerate steroids working with dietitian. But thanks for sharing your little bits on the history. That's super helpful Carol. And thanks for sharing publicly too, because I'm sure there's other people suffering. So gosh, this is a tough thing because one of my goals in life with the documentary and book and just speaking and teaching is how do we really educate other physicians and more physicians on board so that US patients have the option and have more patients, have more doctors who really understand. So that's definitely one of my missions and I'll keep doing everything I can to educate my colleagues because you really have to, we're taught in medical schools to get to a diagnosis and then stop there because that's the answer, right? As a functional doctor, that's where I start because the next question is why? Why did this happen? Why did this patient go down this path and what can I do to reverse it? Carol, that's what you're talking about there is the difference is someone really questioning being a good detective and trying to help you find answers. And I know as a patient, it's got to be so frustrating sometimes because these doctors, you know, again, I love my colleagues and there's so many brilliant, amazing doctors out there, but some of them haven't really had that inquisitive curiosity to help you find answers. And especially some of these lesser known mass cell issues and things, if they're not really looking into that, they may miss it. So I think you just become educated, you can become an advocate, see other physicians if needed, get second and third, fourth opinions. I remember when I was diagnosed with Crohn's disease, this was 20 years ago. I sat with my gastroenterologist and he said, Jill, this is lifelong, there's no cure. We're going to start steroids and I want you to start steroids. I actually didn't do that. You're probably going to need multiple surgeries. This is lifelong. It's incurable and diet has nothing to do with it. Yeah. And I sat there and I thought, gosh, I don't know a lot. I'm just a third year medical student, but that doesn't feel right to me. And so just like I was a patient, just like you were, I was just a medical student and it didn't feel right. And I fired him and didn't go back. And I went on my own journey to try to find answers. And I found Elaine Gottschall's specific carbohydrate diet, which at the time was touted to be able to help with Crohn's and colitis. And I thought, what do I have to lose? And I went on the diet gluten free and specific carbohydrate free. And my symptoms were almost completely resolved in two weeks. Now I always say I wasn't cured. It took several years to get the microbiome balanced and to really feel like I consider myself completely cured from Crohn's disease. No evidence, no symptoms. However, it took several years, but diet did have something to do with it. And it was the start of me understanding how powerful diet is, but I had to become just like you, my own advocate and decide who I would trust and who I would not and what kind of opinion I would seek. So I just encourage you guys to do the same because you're in charge and you can continue to seek opinions if you don't find what you're looking for. And trust your intuition. There was this piece of me that thought, that doesn't sound right. I can't imagine that diet doesn't have anything to do with this. And so I trusted that piece of my intuition and I went and I found diet does have a lot to do with it. So Carol, good luck to you. That's a tough thing. And I totally understand Curtis. For those are cash limited due to Lyman mold. Do you know of affordable education sources so that we can know what's happening and explain to others? Love that you have a thank you for your kind words, Curtis. You know, that's one reason I come on here. I'm not getting paid to do this. I'm just doing it because I love talking to you, feeling like I'm somewhat connected, even though it's virtually and trying to give more information and be there in some way. It's one reason if you haven't been to my YouTube channel, we have like 60 plus videos with experts. Again, I just do that for free because you can go listen to those all day long. There's like 60 plus hours of interviews and I've literally brought some of the world's experts in Lyman mold on my show because it's great information that should be public. So go there. That's all free. You might be able to find if you just search by the topics or by the doctor. There's lots and lots of videos on Lyman mold and you can share those with family members. There's one with Dr. Richard Horowitz done one with Dr. Dan Kindler, both online. There's another with Dr. Mary Ackerly and gosh, I can't remember off the top of my head but lots and lots of interviews on mold online. And I think sometimes that helps if friends or family or people in your life don't understand what's going on, you can go there. And part of my goal with book documentary and the things that are coming is to really, really bring the word to the public and help them to understand some of you and how you've suffered and other patients who might not have answers. So I'll keep doing what I'm doing and thank you, Donna. Taylor. Hey, Taylor, do you know any good coffee enemas? Yes. So this is hilarious because I do have one on my store and I'll tell you why and why I'm even mentioning it here for you guys. So I went to Switzerland before COVID and I was there at a Swiss mountain retreat for a liver detox. And it was just one of the most spectacular experiences I'd ever had. Just absolutely amazing. And the detox went really well. I was one of the youngest people there. It was actually a lot of people in their 60s, 70s, 80s. And they all did so well in this detoxification program. And I was always like, how are these patients who are not super healthy and certainly not super young doing so well? Well, part of the protocol there was one time during that week of detox, a colon, hydrotherapy treatment. But more than that, it was daily coffee enemas. And in Switzerland, they had these wonderful little kits that were self-contained, super easy to use. You used an instant charcoal coffee that you put into a bottle, fill it with the warm, clean tap water, shake it up, add the tube, and there you have it. So much easier than the things we could have gotten in the U.S. with the hang the bag, filter the coffee, cool the coffee. So all that to say, I have those in our store. They're imported from Switzerland, guys. So these are directly from the Swiss mountain clinic. I'm going to put a link in the feed here so you can see it, Taylor. But I'm a huge fan of this because it's so easy. It makes it super, super easy. When you get the kit, you get the order. I put the link in there that has the coffee with it. So you have the kit plus the coffee, but you can get them separately. That coffee does about 21 enemas. So you can use that if you use it a couple of times a week. It'll last you a long time. I'm a huge fan because this will increase your glutathione production by about 600% and very gentle, very safe. And the instructions and everything are included in there. So I put that link in the bottom here if you're interested in knowing more. Hey, Ben, physicians often do not treat empirically or order the proper test in the acute phase. What's your recommendation for testing? Once a suspected bacterial infection reaches a chronic phase or maybe more elusive outside the circulatory system. Ben, this is such a great question. It really shows your insight into understanding how this works because often even with some of the best tests like hygienics, we're testing immunoglobulins. So we're checking the immune reaction to an infection. And there are docs who, especially if you get an IgG reaction. So IgM goes up first in the first six to eight weeks. That usually goes down and then IgG will go up and stay up. So if you had varicella at five years old, even in my age, you're still going to have titers of varicella that are high for IgG. If you had COVID, that depends a little less long lasting in some cases, but the IgG may stay high for a while. So a lot of times when you test, like for Borrelia or Bartonella or Babesia, these IgG levels, docs may say, well, how do we know that those are accurate for acute infection? And this can be tricky. There are, gosh, this could be a whole lecture and it's really complex. I still like a Western blot for Bartonella, Babesia, Borrelia, et cetera. But there are more accurate testing such as PCR and fish that's in situ hybridization, which actually detects through a highlighted fluorescent tab or tag. It detects the actual bacteria in the blood. So for real accuracy, I often do fish and PCR. And those can be done by conventional labs and also by things like Igenics. And usually you can get to a determination. Viruses are tricky because you can just see titers. And again, you don't know if it's past or current, but I think one of the governing organizations talks about titers that are four times the normal limits being a positive. And I usually use that as kind of a guideline. So if a patient has a clinical picture that looks like a viral infection plus a titer that's four times the normal limits, that's the direction I'll usually go for a positive viral test. But as you well know, Ben, it can be a really tricky thing to diagnose. Hi, Danielle. First diagnosed with mold illness, black mold, had an evaluation on my house, and I'm currently not living. After a year of treatment, lifestyle changes, no improvement. Just diagnosed with Lyme, tick-borne bacteria. Keep hearing that it takes a long time to heal from these. How do you know when long enough with the treatment and what to look for something else? Oh, gosh, these are great questions and things I deal with every day in the clinic with patients. So for Lyme, first of all, you've described, Danielle, that there was mold toxicity. I'm suspecting mold toxicity weakened your immune system and allowed these other infections to start to pop up and cause problems. So one of the things, funny, I just got done doing an interview for a mycotoxin summit with Dr. Eric Gordon. And we were talking about this very issue, because what happens is that mold in the environment will weaken your immune system, and old infections will tend to pop up and cause problems. And if you start with detox and really get out of the environment, clean up the mold, get your immune system back online and healthy, sometimes you don't need to be aggressive on the infections. And that's important. So I would not jump to antibiotics first until you're sure that the mold detox has been successful. And then when you are treating Lyme or co-infections, there's multiple routes. There's a lot of herbal routes. And if the patient agrees, sometimes I'll start with those. I think they're less effective for full eradication, but depending on the doses, that can happen. The problem is with herbal routes, at least in my experience, it's more common to have someone stay on the drops, and they feel great. But if they go off the drops, they can relapse. So sometimes they're stuck, not really stuck, but they're on the drops, they feel amazing. But if they go off the drops, they don't always maintain that level of success. But again, that's where the immune system comes in, because if you can support the immune system, you usually have a lot more success long-term. That's the drops. Antibiotics, I don't love antibiotics, but in some cases it can be absolutely powerful. Game changer, if you know how to use them, I do use antibiotics in patients. That's typically a four to six months treatment or longer. And what I always want to do is within six to eight weeks have some progress, some turnaround. I won't keep pushing if I don't see progress of some sort. So I'm constantly checking in with the patients and making sure that they're having some sort of progress before I push the antibiotics. Okay. Misty, do you recommend the diet for ulcerative colitis? Yes. So specific carbohydrate diet has a real good success rate, and that's a great place that you don't know where to start. I've had a lot of success with that, especially with ulcerative colitis, maybe even more so than Crohn's disease. So I think that's a fantastic way to start. I think diet is crucial as a starting point with Crohn's and colitis. So the answer is yes. Yes, yes. Hey, Emily, thanks for jumping in here. I hope you're doing well. Thoughts on neurofeedback. I am a huge fan of these somatic behavioral types of therapies because so often with chronic illness, many of you listening understand this. It can be, it can be so hard. It can make us feel hopeless or isolated or there's lots of emotions that come up. And so dealing with not only that limbic activation, which is a trauma response to illness, but also our programming around illness. So neurolinguistic programming, neurofeedback. Butechal breathing or any sort of breath work, yoga, Tai Chi, movement work, walking, being in nature. I'm a huge fan of the PEMF mats. You can, you've heard me talk about it. My mat lies right here and I use it every day. In fact, I was recently in LA and I took a travel mat with me because I didn't want to be one day without it. The higher dose now makes a travel mat. So I'll have to put a link in there too for you guys for the coupon if you want to know about that because it was awesome to have that on my trip. I used it every day that I was gone. So PEMF and then somatic behavioral therapies like thought field therapy, brain spotting, EMDR, any sort of therapy where you're touching base with your somatic system and trying to reprogram that fear and that fight or flight and that trauma response. All those things are super helpful. Sound therapy, birnal beats, thought field, EMDR I mentioned already, try to think of all the things I haven't mentioned. DNRS with Annie Hopper can be helpful and goop to program. Those are two dynamic neural retraining programs as well. So lots and lots and lots of things you can do for the Olympic system and really, really critical when you've had a chronic illness. There's a trauma response and you need to address that as well to get well. So thanks for asking that. Emily, neural feedback is also super important. Do I work with children? Absolutely 100%. Here in Colorado, Dr. Suzanne Godzid does work with pan and pandas. She's a neurologist that's functional medicine trained. If you're anywhere near Indiana, my friend Ellen Antoine and her husband Scott do work with pan and pandas. So they're a great resource there. And you can always message me here. I can check in later and you can search ICIGroup.org. So ISEAI.org has doctors that are trained in mold and lime and that's a great resource. IFM.org is just functional medicine trained doctors. So those are two places where you could go and search by zip code for someone who could help you. Thank you, Gianni. Bless your heart. What do you do with high IgM levels? Rumi is clueless. Okay. So IgM is one of the immunoglobulins. And if they're high, we can see subclasses of IgM, IgG, IgA, any of those could be high or low. I actually see that commonly with Bartanelle and Lyme disease. The first thing I would do is rule out an infection that's contributing to this dysplastic syndrome. However, even though that's probably not an early dysplastic, like early kind of my, we call them myelodysplastic syndrome. They're almost like a pre-cancer of the bone marrow. You would want to see a doctor to rule that out because it's possible that it's a myelodysplastic syndrome. So if you've ruled that out with hematology, then you can assume it could be infection and start testing. But I also wouldn't assume that it's not myelodysplastic in nature. I would rule that out first because you want to make sure it's not one of those conditions. Radha, how do you diagnose MCAS? So I have a great article on MCAS in my blog. I'm going to try to find that because if I wait till later, I'll forget to add this to this for you guys. So I'm going to do that while I'm talking. There's actually quite a few. If you just search my blog and MCAS, you will find all of them, but there's one that really outlines it for you. And super helpful. So how do you diagnose? Well, clinically. So all the symptoms of MCAS, which are usually histamine related, there's a list in this article that I'll share. And then you can do labs, which are listed there too, like triptase, urine, prostaglandins, and histamine in the blood, but sometimes people will not come back positive for those and they'll still have MCAS. So I'm putting a link to this article right here in the feed. So I've just got a few more minutes today, but I'm going to get as many questions as I can in. I hope I'm not talking too fast for you. Okay. What are some of the best practices get the basics, foundations, right? For supporting general metabolic health and immune system, in particularly. Okay. Foundational stuff. So we'll talk about that. And testing for Lyme if it's been undiagnosed. Okay. So foundational. So the first thing is sleep. So getting a good night's sleep, absolutely critical. And so many things you can do for that. As far as nutrients, melatonin, five, HTTP, theanine, GABA can all be helpful. I find somewhat of a ritual. If you have a practice, you do every night can be super helpful getting your body kind of ready to wind down and go to bed. I usually make a cup of hot ginger tea with lemon. Sometimes mango ginger or lemon ginger, whatever I have on hand. And then I will take a hot epsom salt bath almost every night. And this is wonderful ritual I have that just calms my body down. I have a weighted blanket, a 20 pound weighted blanket. I think gravity is the company. There's a ton of other great ones out there. And I love my weighted blanket. It's like calming to my nervous system. I never in a million years, I kind of laughed at it a couple of years ago. And until I got one and I love my weighted blanket. I use my PMF mat before bed on level one, which is a shuman frequency. It's like the earth's surface. And it really enhances your deep sleep. And I love my bed. It's not like I'm not getting anywhere. You know, I'm not getting anywhere. So I'm not getting anything. I'm not getting any objective in my aura ring, change in the amount of deep sleep I'm getting. So those are just my rituals that I do before bed. And I sleep really wonderful, really deeply. I have no trouble sleeping. But I know for some of you that trouble sleeping, that's a foundational issue. So get that right first. Diet we can't ignore. And I think a clean diet is absolutely foundational as well. So no gluten, no dairy, no sugar. Those are kind of non-negotiables. Often I'll also have people go off any allergens like peanut, egg, soy, corn and alcohol. So that's kind of the anti-inflammatory diet. The more extreme versions which some people need to do are like an autoimmune diet or an autoimmune paleo diet which would be legume free, grain free for paleo and nuts and seed free for autoimmune paleo. I don't think everybody has to go to that extreme. It just depends on how weak your gut is, what situation you're in and nutrients. Oh gosh, I could spend an hour on nutrients. At the basics, I'm not even always a huge fan of multivitamins because I like to individualize the treatment for the patients because they may need more of this B, less of this nutrient but at the very minimum you want minerals and you want B vitamin. Most people need extra zinc and magnesium. If you're post-menopausal you may need zinc plus copper but many people need more zinc than copper. You just wanna check those ratios. Selenium can be key for thyroid function for making glutathione. I'm a huge fan of liver support, anesthetial cysteine, glutathione, selenium lipoic acid, milk, all of those things really powerful. Anti-inflammatory support would be the sum of the stuff we talked about earlier, Boswellia, curcumin, resveratrol, Chinese skullcap, all really wonderful additions. Sulphorophanes are from broccoli sprouts. They're incredibly powerful for detox. So those are just some of the core things. I usually give people a fish oil or have them eat fish to get anti-inflammatory. And I'm a huge fan of spore probiotics. So those are kind of the core things that most people would want to take at a bare minimum. Okay, let's see. So I'm gonna go just another five minutes so I've got just a time for another question or two. Nicole asked what to recommend in testing for Lyme. If it's been undiagnosed, I'm a huge fan of iGenX. iGenX is very expensive and I'm so sorry I don't have any control over that. There are, Vibrant has a Lyme test that's a little more affordable. I do still feel like iGenX is the gold standard. So if someone really has been around and they want a diagnosis, I will go with iGenX because I know I'm gonna get the right answers. So I would just buy the bullet, get the iGenX test. But if you can't afford that and need testing, you could do a regular Western blot for Lyme on a conventional lab. The yield can be negative unless you got bit by a East Coast tick. But it's still worth trying that. And then, like I said, Vibrant does a Lyme test, it's very good and a little bit more affordable as well. Okay, thanks, Nicole. Have I seen patients develop liver disease? Positive, she is positive or someone has positive AMA mitochondrial antibodies which have been in liver disease and had. So what I see, I see your list of Lyme and Bartonella and MCAS, peripheral neuropathy, et cetera, you poor thing. You've had it all, huh? So what I find is Lyme is a definite trigger. So is mold for TGF beta, which is a driver of autoimmunity. So frequently we see someone who presents with autoimmunity but the real trigger, a driver of that is Lyme or mold or some of these chronic things. So not always can we reverse autoimmune disease but sometimes we can. And the one hope for reversing autoimmunity is going to find what is that trigger that triggered your positive antimitrochondrial antibodies and trying to reverse that. And like I said in the beginning, it's often one of two buckets. It's toxic load or infectious burden. So if one of those buckets is the issue then taking care of that bucket and of course it's more complex than just, you know, it's more complex than it sounds but that's the direction you would go in reversing autoimmunity. And I've seen miracles as long as you get to the root cause and try to reverse that infection or toxin. Hey, Tony, glad to have you join us. Diagnosing mold colonization on top of toxicity. Okay, so this is a great question because we can have mycotoxins in the urine which show exposure and can show colonization. Great plains oats will do the furans as part of their panel of fungus and those are usually related to aspergillus. So that's the way we can do it is if we see some of those markers on the Great Plains Oat or on the urinary mycotoxin test those are good indicators that there may be colonization. And then I asked them about symptoms if their guts bloated or if their sinuses are congested or things like that. And we can treat any of those locations with antifungals or antifungal herbal supplements and biofilm disruptors which are usually key as well. Hey, Ben, lymph fluid tests by needle aspiration. Let's see where did your question go there. Accurate cytokines worth testing. So lymph fluid test, you know what? That's not something I do in my clinic and I'm not super familiar with that. So I'd love to know more but I don't know if I can answer you well on that topic. Cytokines, I do cytokine panels on LabCorp and also precision, let's see, diagnostic solutions I think does a cytokine panel. These can be helpful because if you see a lot of IL-6, IL-4, you kind of know that but it's not like we have one. Well, there are drugs now that treat some of these cytokines. So if you're looking for like dexapants or some of these drug therapies it can be helpful to know but I agree with you they're a little nonspecific. I think that's a great question because sometimes I do it once or twice to prove that the patient is definitely cytokine driven and I think that's probably what we'll see if we would test all of our long haulers and see what's going on. I'm guessing their cytokines would be elevated on the panel. I think that's exactly what we would see. Okay. Oh, thank you for your thanks. CD4, so high in a child. So this last question, Katherine, I'm guessing you mean C4A, you put CD4A that I think C4A would be probably what you're looking for there. That's a complement split product that we see elevated with a mold exposure. Now there's other things that could cause that but very frequently it's a recent mold exposure. So I would guess that there might have been an exposure somewhere for this person you're asking about. So well, everyone enjoy this beautiful weekend. I am so glad you took time out to join me. This will be recorded. This will be on my YouTube channel which is another thing I didn't mention at the onset. If you have not gone to the YouTube channel just search for Dr. Jill Carnahan. You're gonna find loads and loads of interviews. All of my previous Q and A's are there and this is all free. So go there, watch whatever you wanna watch, share with your friends and please do subscribe that way you'll be notified when I put new content out. And I will just end this Friday with happy weekend to you. Love to you all. Thank you so much for joining me today. We'll talk soon.