Finding Your Way With The Complicated Patient was hosted by Gordon Medical Associates and was held in Santa Rosa, CA on September 26, 2015.  Gordon Medical is one of the clinics that I have the utmost respect for; their practitioners are top notch and really care about helping people.  The conference was a lot of fun; almost like a reunion seeing so many people that have come into my life over the years through my journey with chronic illness.  

The below represents only a subset of the great information shared at this event.  The event was recorded so I recommend watching the GMA web site for DVD ordering information.  You will learn so much more than I can possibly share below.

Disclaimer: Nothing in this text is intended to serve as medical advice. All medical decisions should be made only with the guidance of your own personal medical authority. This information was taken as notes during the conference and may not represent the exact statements of the speakers. Errors and/or omissions may be present. If you have any corrections to the content listed below, please Contact Me.

Note: As this information may be updated as any errors are found, I kindly request that you link to this single source of information rather than copying the content below. If any updates or corrections are made, this will help to ensure that anyone reading this is getting the most current and accurate information. 

One of the themes of the day was that in the sensitive patient, what may be considered a normal dose or a standard treatment is often way too much for a sensitive patient to tolerate. Treatment options and dosing have to be considered very carefully in sensitive individuals.

Eric Gordon MDEric Gordon MD started the day with an "Approach To The Complicated Patient" and shared:

  • Uncomplicated patients respond to treatment and improve. The diagnosis flows from the physical and lab findings.
  • The complicated patient is one where success is measured in small improvements. They improve but often remain unwell. It takes years to get well. They were the sensitive one in their family. They may respond poorly to treatment. The Herxheimer response is common even with low doses and shorter treatments.
  • When Herxing, they may need to stop treatment and it may still take 2-3 days or longer before they are ok.
  • There are multiple genetic and epigenetic lesions and multiple imbalances. There are persistent triggers or triggers that have left an imprint. There is a new equilibrium that is resistant to change.
  • In general, we are making too much of genetics and SNPs.
  • The biggest change in his work in the last six years was to develop tools to support connective tissues, fascia, and the musculoskeletal system.
  • Some bugs may stay behind or leave behind a cellular memory.
  • When you fix a car, you have to get it right. When you fix people, you just need to get close and the body does the rest.
  • There may be genetic weaknesses, but if you have a true genetic problem, you may not live past 5 or 10 years of age.
  • Most diseases are combinations of 50-100 different genes. Genes is the wrong level to be looking.
  • If an enzyme works at 40% of normal, you may have more difficulty.
  • The functional medicine model only goes so far in the complicated patient; fixing hormones may make some people better and others worse, for example.
  • You need to identify the persistent trigger and remove it if you can. Identify the most irritable level of being; this is the place to listen. If you can't touch that one, look for something you can do. Listen to what feels safe to the patient. Sometimes every doorway is boobytrapped to protect the status quo.
  • There may be genetic and epigenetic influences - methylation, mast cell activation (in people that Herx heavily), inability to neutralize mold toxins, allergies, autoimmunity, porphyria, oxalates, autonomic dysregulation, and "forme fruste" (mild forms of disease not recognized by conventional medicine).
  • Anything that upregulates the cytochrome P450 system can trigger porphyria.
  • Antibiotics can kill a microbe in the gut that was previously helping to breakdown oxalates; kale is high in oxalates.
  • There can be imbalances at multiple levels - physical, biochemical, and psycho-spiritual.
  • Chronic inflammation coupled with old injuries can lead to problems. Places of past injury may have lower circulation and lead to an increase of toxin deposition in those areas.
  • External influences such as environmental toxins, metals, man-made chemicals, herbicides, pesticides, VOCs, EMFs can all impact the system. Organisms such as Lyme, Babesia, and mold all have the ability to produce their own toxins.
  • There can be numerous infections such as parasites, Lyme, Bartonella, Babesia, Ehrlichia, Rickettsia, Mycoplasma, Chlamydia, EBV, HHV-6, CMV, Enterovirus, and more.
  • Typically there is a burden of metals, mycotoxins, and microbes.
  • There can be a mental story that keeps us ill.
  • We are all neurotic and the body can respond in neurotic ways.
  • There is a Cell Danger Response based on the work of Robert Naviaux PhD where mitochondria reduce energy production when sensing a threat.  When the Cell Danger Response is stuck on, patients don't respond to standard disease models.  The original event that triggered the response may not even still be present, but the response persists and the inflammation patterns continue.
  • Psycho-social considerations raised the wrong way can make the patient worse; there is no undamaged human being.
  • Chronic Inflammatory Response Syndrome (CIRS) exacerbates underlying "weirdness".
  • Infections trigger anxiety, anger, and depression that can destablize even the most solid folks.

Wayne Anderson ND talked about "The Sensitive, The Toxic, and The Complex Patient" and shared:

  • We should never compare ourselves to other Lyme patients.
  • A sensitive patient does not have as much brain fog or pain as the toxic patient. Sensitive to small doses of drugs and herbs. Fewer neurological symptoms. Reactions may change and not be the same reaction; move from one place to another. May do better with RX options than with herbs. Recover quickly when leaving a stressful environment. Sleep ok. Can be light and sound sensitive. Can exercise with no post-exertional malaise but may develop exercise-induced injuries. May have food allergies. Can be talkative and disorganized with difficulty listening. May have a weak musculoskeletal system. May have confusing hormone levels and optimizing them may not help. Has a broader weave in the iris when more sensitive and may show rings in the eyes that may represent a stressed nervous system.
  • Many hypotheses exist on why a sensitive patient is sensitive:
    • Metabolites become toxic when out of balance or in excess (histamine, oxalates, etc.)
    • Toxic products result due to inefficient gallbladder functioning
    • Toxic products result due to inefficient phase 1 and phase 2 liver function
    • Toxic products result due to toxins from bacteria in the gut
    • Toxic products result due to leaky gut
    • There could be a head injury
  • What makes a person sensitive? Endotoxins where as the toxic patient also has a high exotoxin burden. May have high histamine or mast cell issues, mineral imbalances, dehydration, pH imbalance, ammonia, sulfates, neuotransmitter issues, oxalates, porphyria, pyrroles, and more. Is a waste producer.
  • DAO, or diamine oxidase, eats up histamine and giving DAO can help in some patients.
  • He likes to use the 23andme results and reviews them with the report from MTHFRSupport.
  • If someone has SNPs for glutamate, that may lead to being excitable and anxious.
  • If the gallbladder is not working, the patient is a waste recycler.
  • Phase 1 and Phase 2 imbalances lead to not clearing toxins and insufficient liver function is also often seen.
  • The porphyric patient dumps iron into the liver; copper can accumulate in the KPU patient due to low zinc.
  • Had a number of head injury patients that did HBOT which then presented like a standard Lyme patient and became more treatable.
  • The sensitive patient is a toxin producer and recycler.
  • Many hypothesis on why a toxic patient is toxic:
    • Metabolites that are toxic build up and are in more excess than in the sensitive patient
    • External toxins compound endotoxins (internal toxins)
    • Poor functioning of detoxification organs lead to imbalances in intracellular and extracellular spaces
  • The sensitive patient reaches a threshold and then becomes a toxic patient.
  • Lyme and mold destabilize a person in the ways they are sensitive. Vulnerable areas get turned on and manifest with their own patterns.
  • The environment has a lot to do with it. There can be chemical toxins and mold toxins.
  • There is more of a neurological presentation as well as brain fog and pain; including joint pain.
  • The sensitive person may have more muscle pain and the toxic person more joint pain.
  • Toxic person can react badly to RX drug. They can take much longer to recover from exposures.
  • They are better after exercise but need 2-3 days to recover if they overdo it.
  • Pain is more generalized; whereas an infection patient has more localized pain.
  • They are often taking many supplements and not doing much better. Can have more acne.
  • A brown ring around the iris may present indicating colon and toxicity issues.
  • They are a waste producer. Can have both exogenous toxins and endogenous toxins; the exogenous compound the endogenous. The goal of treatment is to unload the patient.
  • Neurotoxins can be mold, fungal, Lyme, chemicals, metals and more; these are lipophilic and attracted to fat; they move intracellularly and cause inflammation.
  • Detoxification is a river. The end of the river is the bowel; the middle is the liver, gallbladder, lymphatics, and kidneys; the beginning is the cell emptying toxins. You cannot start at the beginning if the end and the middle aren't first cleaned up.
  • Toxic patients are often holding in, emotionally blocked, and can feel stuck.

Neil Nathan MD with Susan McCamish CTN of Beyond BalanceNeil Nathan MD spoke on "How to Approach the Sensitive Patient" and shared:

  • 60+% of his practice are sensitive patients.
  • They likely get more of the sensitive patient referrals but the world is also becoming more toxic.
  • They can be sensitive to stimuli such as sound, light touch, smell, tastes, and chemicals.
  • They can be sensitive to ingested materials such as foods, medications, supplements, homeopathics; and even water.
  • They may be sensitive to EMF and to mold.
  • Mold is the premier sensitizer that throws people off the track.
  • There is Lyme, particularly Bartonella, in his sensitive patients.
  • Believe what they are telling you completely; no one is lying to you.
  • Sensitizers may be mold, Bartonella, secondary porphyrias, Varestrongylus Klapowi (VK) worm, mast cell degranulation disorders.
  • Mold can act as an allergen, an infection, or a toxin (or a combination of these). His focus is on mold as a toxin; though you can have all three.
  • 25% of people have a genetic predisposition via HLA that makes them unable to process mold toxin.
  • The most significant of the molds are Stachybotrys, Penicillium, Aspergillus, Chaetomium, Wallemia , and Fusarium.
  • Walking in the woods and getting sick is allergy; not toxicity.
  • Inside a building, there is no competition like their is outdoors. This can lead to sick building syndrome.
  • Sadly, patients are often staying in the sick building to heal and this leads them to staying sick.
  • The term "mold" in the Shoemaker realm includes not just fungi; but Actinomyces, Mycobacteria, VOCs, beta glucans, hemolysins, mannans, proteinases, and more.
  • Mold is the trigger for most MCS. Mold also triggers EMF dysthymia.
  • EMF may shift the brain to delta waves; the light is on but nobody is home.
  • Mold exposure predisposes one to food allergies and autoimmunity.
  • Mold symptoms include ice-pick or lightening bolt pains, vibratory sensations, numbness and tingling in odd places like the belly or center of the back, and more.
  • Both mold and Bartonella can be causes of internal vibrations.
  • If you cannot process mold due to HLA, you can only use the bile to excrete it, but then it can be reabsorbed and cannot leave the body.
  • The sinuses and GI tract can be colonized by mold based on Brewer's work. The patient is making their own mold toxin internally.
  • There was 94% improvement in Brewer's approach with 100 patients.
  • MSH deficient people develop MARCoNS which makes a biofilm layer and prevents antibiotics and the immune system from getting to it.
  • VIP downregulates cytokines. If you cannot make VIP, you cannot control inflammation.
  • When you get mold out of the body, VIP can help to reboot the system. It won't work though if you don't follow the steps, remove the source of the exposure, etc.
  • Visual Contrast Sensitivity (VCS) test can be impacted by mold, Lyme, and mercury exposure.
  • Shoemaker looks at VIP, MSH, TGF-b1, C4a, VEGF, MMP-9, ADH, Osmolality, MARCoNS. These can represent Lyme and coinfections such as Bartonella, Babesia, Ehrlichia as well as mold. They are not clear indicators that mold is the problem.
  • Treatment often begins with Cholestyramine. Nathan has found that his patients often tolerate only very low doses initially such as 1/8 teaspoon every 3 days.
  • Actos helps with the way the body processes toxins. Cholestyramine can help to improve detoxification but not in complicated patients. If it binds more than the patient can process, they can get worse.
  • Binders "adsorb" or hold on to the surface gently. They can pull toxins into the body at a rate that the body cannot handle in some people. They can pull toxins faster than the body can process them.
  • For ADH, some may use Vasopressin.
  • Adrenal deficiencies are almost universal. Look at DHEA, cortisol, and mineralcorticoids. Treat MARCoNS.
  • Melatonin may help for sleep when MSH is low.
  • C4a may be lowered with EPO (Procrit); C3a with statin medications. Feeling great in high altitude is an indicator of C4a or EPO-related issues.
  • When VIP is low, VIP is used nasally only when the person is out of a moldy environment and has been treated for MARCoNS.
  • Nathan likes mold plates to visualize that mold is present, but 1/2 of the species that may appear are not toxic mold species.  Often requires the plates to be analyzed.
  • Patients will not get well if they stay in a moldy environment.
  • Mycometrics ERMI is used to evaluate the environment.
  • The Brewer Model utilizes the urinary mycotoxin assay from RealTime Labs; they recently added gliotoxin to the assay as well.
  • Can take 1-2 years to treat. Uses binder for toxins along with nasal sprays and oral treatments to remove colonized molds.
  • For trichothecenes and aflatoxin, may use activated charcoal, bentonite, and chlorella. They may be taken together. Should be 2 hours before or after a meal. Low and slow is best.
  • For ochratoxin, Cholestyramine or Welchol may be used. Don't use Cholestyramine with sugar as it feeds mold.
  • Welchol may be used at 2 tablets three times day but can be too much for sensitive patients.
  • Killing mold in the sinuses may be done with various nasal sprays such as Amphotericin B, Nystatin, or Ketoconazole as well as options to address biofilm. Only 40% tolerate the Amphotericin B; Nystatin is much more gentle.
  • GI tract may be treated with oral options. Biofilms may be addressed with Interfase Plus or Beyond Balance MC-BFM. Sporanox, Ketoconazole, and Amphotericin B may be used to treat mold in the GI tract.
  • Argentyn 23 may be used orally and nasally and penetrates biofilms. It can be synergystic with antifungals. Many mold patients have Candida as well; Diflucan works well for Candida but not for mold.
  • Re-exposure to molds must be avoided.
  • Chlamydia pneumoniae can be difficult to eradicate and is common in Lyme.
  • Bartonella antibiotics may kill Chlamydia which can lead to a porphyrin release from the Chlamydia and lead to a worsening of symptoms.
  • If the Herxheimer is 1-2 days, it may be a herx; if prolonged, it could be related to porphyria and one may want to consider Chlamydia.  http://cpnhelp.org
  • High protein, low carb may be helpful for Lyme and mold.
  • High carb diet, including glucose, may be used when treating Chlamydia with secondary porphyria.
  • Mast Cell Activation - true mastocytosis is rare, but Mast Cell Activation Disorders and extreme reactions to histamine are seen.
  • Quercetin, HistDAO (often very helpful), Ketotifen (too strong for some patients), Perimine, and Gastrocrom may be used.
  • Gliotoxin can be produced by Candida. Candida also produces other toxins. The addition of this to the RealTime Labs urinary mycotoxin testing should be helpful.
  • Dr. Gordon mentioned that when you take toxins out of the body, other toxins in the body will often redistribute.
  • Dr. Nathan mentioned that Candida has become more resistant over time to everything that is being done. Mold is tougher than Candida. He has not seen enough to suggest that the herbs work well for mold colonization.

Wayne Anderson ND spoke on a "Layered Approach to Healing" and shared:

  • The complex patient often has Borrelia, Babesia, Bartonella, Mycoplasma, Rickettsia, viral encephalitis, and more.
  • The complex patient has elements of the sensitive patient, the toxic patient, chronic pathogen burdens, and various comorbidities.
  • There are four spheres of influence - metabolic, pathogens, immune system, and comorbidities.
  • Metabolic consists of endocrine, detoxification, pH, hydration, nutrition.
  • Pathogen consists of bugs (viral, fungal, parasite, bacteria), biofilms, dental cavitations.
  • Dental issues are a big, underappreciated issue in non-responding patients; these may be root canals, cavitations, or other dental issues.
  • Immune system consists of dysregulation, autoimmunity, and secondary immune disorders.
  • The immune system is always doing the best that it can and is making a constant effort to bring balance.
  • Comorbidities consist of disease process, organ damage, structure, psychological, trauma, energetics, environment, and lifestyle.
  • The immune system responds to the dominant pathogen at any point in time. The dominant pathogen will change, the immune system will refocus, and symptom presentation may shift.
  • The immune response can be clear, muddy, or a mixed pattern.
  • Clear is when the immune system has a vital response that recognizes an infection and the symptoms are related to the specific pathogen.
  • Muddy is when the immune system is not responding as appropriately and the symptom presentation is much more difficult to interpret.
  • There can be a mix of clear and muddy in some patients as well.
  • The microbes are not the symptom driver; but the immune response is what drives most symptoms.
  • The immune system is constantly triaging the dominant pathogen; as the load of one goes down, symptoms of another come up.
  • There are layers which include the outer (current challenge), second (next dominant pathogen), third (weaker pathogen) and foundation (likely genetics).
  • Borrelia often is protected by its gangsters; Bartonella and Babesia. Borrelia is the Godfather.
  • Our knowledge of coinfections continues to evolve. In 1985. it was all Lyme. In 1990, Ehrlichia came into the picture. In 1997, Babesia. In 2003, Bartonella. In 2010, less about which ones are present but how strong they are. In 2015, the focus is on Spotted Fever and Typhus species.
  • Rickettsia - Spotted Fever and Typhus groups. Intracellular. They infect small vessels and endothelial cells. They can be fatal but can also be asymptomatic. Impact the vascular system, skin, respiratory, CNS, and kidneys.
  • With Babesia, chief complaint is usually mental/emotional. With Bartonella, chief complaint may be pain, joint pain, or headache. With Mycoplasma, chief complaint may be severe fatigue, generalized pain, dry cough; generally seen after the other coinfections are weakened.
  • May use a Challenge Protocol to determine what microbes may play a role - might be RX antibiotics, herbal, or homeopathic. Taking specific antimicrobials and then watching for symptoms that worsen can be very helpful.
  • IGeneX Rickettsia antibody testing includes both Spotted Fever and Typhus.
  • Deseret RMSF Series Remedy can be helpful for some patients with Rickettsia.
  • With Rickettsia, rash is often the chief complaint; can be blotchy. Exhaustion, joint pain, poor circulation, dark blood, vision feels "under water", palms and soles of feet may have red rash. Numbness when putting an arm in a particular position may be more of an issue with Rickettsia. Edema in the upper body vs. a toxic patient which is often the lower body.
  • Viral ecephalitis may exist such as Powassan (can be asymptomatic and 10% fatality), West Nile, St. Louis Encephalitis, California Encephalitis, Western and Eastern Equine Encephalitis and many others.
  • These viruses can develop into meningoencephalitis and may result in permanent neurological symptoms in some cases.
  • The Germans found a "Lyme virus" in ticks in the 1990s.
  • There is a correlation between energy and neurological symptoms. With viruses, when energy is high, neurological symptoms may be mild. When energy is low, neurological symptoms may be severe. With bacteria, when energy is low, neurological symptoms may be low; when energy is high, neurological symptoms may be more severe.

Jeff Greenfield DO spoke on "Navigating Physical and Energy Blockages" and shared:

  • Structure and function are interconnected.
  • There is a tide-like movement that moves through the anatomy.
  • The goal of osteopathic treatment is to affect a more efficient interchange between all the fluid of the body across all of the interfaces.
  • Lyme patients have a discordant frequency in their tissues.
  • In Lyme, there may be a lack of response to treatments, treatments may not hold, CNS motility is diminished, fluid movement is restricted, tissue texture changes, and there is a "Lyme buzz" that he can feel.
  • Lyme Disease Complex sabotages health.
  • Usually, people go into sympathetic overdrive. The sympathetic system innervates every single part of us. It turns off the frontal lobe as we don't need to reason; just run. It shuts off the gut as we do not need to digest.
  • The parasympathetic system does not hit every tissue in the body; the sympathetic system can override the parasympathetic.
  • When the sympathetic system gets turned up, the adrenals go right up as well. When this state is maintained, these leads to adrenal stimulation and adrenal fatigue.
  • If we cannot get the immune system working properly, no herbs or RX medications ultimately matter.
  • We are 70% fluid; 95-99% of the molecules in us are water (small molecules).
  • Constitutional homeopathic remedy will augment several phases and make the symphony work better.
  • He uses many tools including Frequency Specific Microcurrent (FSM), Biosyntonie (silicone discs that convert wave forms), thermography, lymphatic techniques, injections, and more.
  • There is often a positive response to treatment, treatments hold better, fluid movement improves, CNS irritability decreases and motility improves, tissue motion improves, patients feel better, the autonomic nervous system becomes balanced, and immune function improves.
  • He also mentioned using tools like the Biomat. 

Dr. Neil NathanNeil Nathan MD spoke on "Cell Danger Response - A Paradigm Shift" and shared:

  • Mentioned Stephen Buhner's work and how the way he explains what the bugs do in the body has changed the way treatment is approached.
  • We need a new model; a rebooting model. Based on the work of Robert Naviaux PhD. The work is deep and very profound.
  • Before a cell is lysed, the mitochondria of an infected or toxic cell notice the intruder as a voltage drop.
  • As a result, the mitochondria rapidly decrease oxygen consumption and the oxygen concentration in the cell rises; making it more oxidizing as a protective mechanism to shield the cell from further injury.
  • Cellular metabolism shifts to protect us against the bugs - the cell membrane stiffens, antimicrobial chemicals are released, mitochondrial autophagy increases to remove pathogens, DNA methylation and histones are changed to alter gene expression (the cell doesn't want to methylate to avoid further microbial replication), endogenous retroviruses are mobilized, neighboring cells are warned, the host alters behavior to prevent the spread of infection, and sleep is altered to facilitate healing.
  • This could be a central mechanism of the chronic fatigue response.
  • The cell danger response specifics are complex and numerous and not fully covered in this write-up.
  • Purinergic receptors have been shutdown and need to be rebooted.
  • Sulfur metalbolism is impacted; glutathione is consumed and methylation is impaired.
  • Active vitamin D concentration decreases and contributes to inflammation and auto-antibodies.
  • Histamine metabolism becomes a problem.
  • Heme is released from damaged cells and impacts porphyrin metabolism. There is an increase in KPU/HPU.
  • Tryptophan is metabolized to serotonin or melatonin or quinolinic or kynurenic acid which increase IL-6 (inflammation) and impacts the immune system.
  • Lysine opposes the Cell Danger Response and may be worth considering for supplementation. CDR produces low P5P which sustains the inflammatory response.
  • In Cell Danger Response, heavy metals become sequestered in the intracellular compartments.
  • However, a compound called Suramin is being researched as a tool and has been found to resolve the entire dysbiosis in mice.
  • Rebooting the Cell Danger Response may be done with Suramin which has anti-purinergic properties; treats all 19 purinergic receptors. It is used in other countries for Trypanosomiasis.
  • Lysine, P5P, and Tryptophan may be logical options in terms of supplements to assist with the Cell Danger Response.
  • Health Diagnostics and Research Institute is the best option for methylation testing; it is a functional test; not a SNP test.
  • Dr. Nathan then went on to talk about other ways to support/reboot the various systems in the body.
  • Inflammation and immune system - have to determine what is causing the dysfunction. Lyme, coinfections, mold, viruses, fungus, EMFs, chemicals, and dental issues. Supportive options: antibiotics, herbs, colloidal silver, ozone, Bravo, probiotics, FSM, LDA/LDI (low dose antigen/immunotherapy), UVB, biome reconstitution (treatment with specific parasites), homeopathics, IVIG, HBOT.
  • LDI could be a serious reboot for inflammatory response.
  • The immune system used to interact with microbes which we are now less exposed to and as a result, we overreact.
  • Nervous system reboot may be done with LENS, FSM, IV Phos Choline, herbs, fish oil, coconut/MCT, KPU, magnesium, zinc, copper, vagal/ANS treatments with osteopathic manipulation, or Kharrazian exercises. LENS is fabulous for autism.
  • One of his favorite treatments is IV PhosChol. IV PhosChol and rectal ozone can be helpful for sensitive patients.
  • We often need a back door, side door, or trap door to find the right entry point to get into the system. Go slow and be gentle.
  • Review Dr Datis Kharrazian videos on gut/brain axis to help support rebooting.
  • Rebooting the gut may be done with probiotics, Bravo, FMT (not readily available unless one has C. Diff), biome reconstitution, herbal and homeopathic options.
  • Dr. Nathan recommends the book "An Epidemic of Absence"
  • For diet and weight reboot, addressing food allergies, fasting, modified fasting, 5:2 fasting diet (changes metabolism), gallbladder flushes (with proper supervision), and colonics may be helpful.
  • Methylation needs to be considered. Getting the right forms of folate and B12 is important.
  • Mitochondrial dysfunction needs to be considered; may include ozone or specific supplements. Photons, FSM, PDE5 inhibitors, high intensity interval training.
  • Rebooting structure may be done with osteopathy and approaches to restore normal flow.
  • Rebooting CDR may incorporate agents such as Suramin that are antagonists to purinergic receptors. D, Lysyine, methylation, P5P, heavy metal detox, detoxification, and treatment of KPU may be used.
  • Rebooting the energetics may be done by removing EMF stress and geophatic stress, acupuncture, FSM, LENS, CES, TENS, EVOX, ZYTO detoxification.
  • Rebooting the endocrine system may be done with DHEA, Cortef, mineralcorticoids, thyroid medications, and sex hormones.
  • Neurotransmitters may be reboooted with amino acids, FSM, LENS, CES, detoxification.
  • Stress reduction may utilize meditation, Tai Cho, Yoga, Heart Math, lifestyle change, finding one's spiritual path.
  • Rebooting chemical sensitivities may be done with LDA, NAET, DNR, addressing VK worm, and addressing mold.
  • In 150 MCS patients, 95% were positive for the VK worm.
  • "Our patients have been living in houses of ill-reboot".
  • Additional Information: http://www.sciencedirect.com/science/article/pii/S1567724913002390
  • Additional Information: https://health.ucsd.edu/news/releases/Pages/2015-06-10-clinical-trial-for-autism-treatment.aspx 

Alice Prescott DO spoke on "Safely Detoxing the Toxic Patient" and shared:

  • The start of LDA/LDI treatment was EPD (enzyme-potentiated desensitization) and was discovered in England. It was later brought to the United States by Dr. Shrader under the name LDA.
  • It required a very heavily restricted diet for 3 days around the injection at the time. Editor's Note: I did this in the late 90's and had to order special potato flour bagels from Texas and that combined with oven-baked potatoes was all I ate for 3 days each time I did the injections. 
  • The proper dilution is the one that talks to the immune system the best; it is like trying to find the volume and then staying there.
  • LDA/LDI is done very 7 weeks and can also be done sublingually.
  • Ty Vincent MD took LDA and applied it to infections to shift the immune response.
  • Sensitive patients can still have very strong reactions to LDI.
  • In LDI for Lyme, there are 74 different species of Borrelia, Bartonella, Babesia, Ehrlichia, and Coxiella.
  • Autologous LDI can be made from nasal washings, stool, urine, and other fluids.
  • There may be a role for LDI in the treatment of children with PANDAS/PANS which is often related to strep.
  • Good results have been seen with LDI from stool and constipation may improve.  
  • Detoxification starts with hydration - volume, purity, pH, container, and messages (EMFs, love). Looks at ADH and aldosterone levels.
  • Trehalose, Dalektro, and Endure are options to help the body hold water.
  • Bowel health consists of diet, bugs, bad chemistry, permeability, and inflammation. Enterohepatic recirculation is a problem for effective detoxification. Aldehydes, indoles, and phenols may come from microbial overgrowths.
  • Starts with probiotics and sponges (binders).
  • For constipation, thyroid may be a factor. Magnesium or lactulose (can feed bugs in some) may be used; Byron White A-P, chlorella, or Huperzine may be helpful.
  • Diarrhea may be related to C. Diff. May use binders, treat dysbiosis and parasites. May consider LDI.
  • For gallbladder, may do an ultrasound; if calcified stones, Chanca Piedra may be helpful. If no stones, may treat parasites and dysbiosis.
  • Porphyria or Ehlers-Danlos Syndrome could be a reason for a hypotonic gallbladder. Chelidonium majus is excellent to stimulate bile.
  • For the liver, if nauseated or have migraines or worsening neuropathy, could be a liver issue. apo-HEPAT, TOX-EASE, TOXEX, methylation, thyroid, structural work to calm the sympathetic and increase parasympathetic nervous system, neural therapy.
  • For kidneys, NEO-40, serrapeptase, nattokinase, lumbrokinase, RENELIX, nettle, Equisetum arvense. Structural work.
  • For lymphatics, walking, rebounding, hydrotherapy, dry skin brushing, breathing, structure work, ITIRES.
  • For cell membranes, good fats, Phos Choline, Omega-3, coconut/MCT oils.
  • Had one lady that had been "floxed" by prior antibiotic treatment that did very well with Phos Choline.
  • For lungs, nebulized glutathione, NAC, LDA for chemicals/molds/foods, LDI for infections.
  • For skin, sweating, Epsom salts, clay, hydration.
  • Looks at 23andme and uses molybdenum and other minerals based on the teachings of Paul Anderson ND and methylation protocols. Considers porphyrias (often flare with Rifampin and do badly with Actos), pyroluria (more psych/anxiety presentation), high histamines (can build up due to methylation issues or be the results of Mast Cell issues; LDI/LDA may help with Mast Cell Activation Disorder). Uses urine porphyrin testing.
  • Grapefruit juice slows the cytochrome P450 pathway. 

Neil Nathan MD spoke on "Methylation: Evaluation and Treatment" and shared:

  • He put 50 patients on the Rich van Konynenburg methylation protocol. 30 of them had significant improvements in 3 months.
  • Methylation covers 150+ reactions in the body and is important for detoxification, turning on and off genes, hormones, glutathione, neurotransmitters, and more.
  • Homocysteine is converted to methionine to SAM to SAH and back to homocysteine.
  • TMG can be used as a shortcut in some people.
  • In a 30 patient study with CFS/FMS in people that were already treated for all common issues, infections, etc. for 1-12 years and were better but not well, the average improvement with the methyltion protocol was 48%.
  • At 9 months, 15 of 25 had > 50% improvement. 3 of the 5 that dropped out had > 50% improvement.
  • Glutathione improved in 96.6%; after 9 months, all were in normal range.
  • SAM, the main methylating material, increased with the Rich methylation approach.
  • They use a Phos Serine that has several different phosphatidyl compounds.
  • Side effects were seen in 35-50% and had to cut back on the protocol as they may have been pushing detox to hard.
  • Dr. Nathan likes the functional methylation panel from Health Diagnostics and Research Institute. SNPs will prove to be helpful for other conditions; for methylation, it doesn't help much. 39 of them do things in the opposite direction but tells you that you have only a potential and nothing else.
  • 80% of people can use any protocol and it will help 80% of the people. For people that are not that sick, many things work. These same things don't work for the patient population he sees - the other 20%.
  • SNPs had no relevance to methylation treatment outcome; even CBS. You can override the SNPs.
  • Trehalose is superb for building up water chemistry in the gut to help things absorb better and stabilizes SAM.
  • 9 of 25 at the end still had elevated adenosine. This can sometimes be addressed with Acyclovir; not because of its antiviral properties but because it helps to convert adenosine to ATP.
  • He spoke about overmethylation vs. undermethylation. What overmethylation is can be hard to understand; he doesn't see that. Methylation chemistry is not the same in all cellular structures. Can be an overload of SAMe and normal or depleted levels of SAH. Low whole blood histamine level is associated with overmethylation. When you can't methylate, this may be shown by high whole blood histamine levels.
  • Undermethylation may be approached with folate and B12; some can be intolerant to folate if low serotonin.
  • Folic acid, folinic, and methylfolate act as powerful serotonin reuptake inhibitors.
  • Testing for overmethylation is not particularly good.
  • William Walsh looks at biochemical results combined with symptoms to determine over vs. under methylation.
  • Alan Vinitsky has found the methylfolate can lead to anxiety and agitation. He uses a 5:2 ratio of hydroxy-B12 and dihydrofolate to scavenge glutamate; product is MethyLift.
  • Dr. Nathan found that in some patients, MethyLift was not always tolerated; 1 tablet was too much for 50% of his patients and now uses 1/4 to 1/8 of a tablet.
  • Dr. Gordon mentioned that everybody responds to something sometime. 

A couple of notes I took from the Q&A session:

  • TGF-b1 is a non-specific measure of infection; can be mold, Bartonella, etc. Dr. Nathan doesn't use it very much anymore.
  • TGF-b1 should be elevated in tissue, not in the blood stream; an indication that TReg cells are not working when elevated in the blood.
  • Dr. Tapan Audhya from HDRI mentioned that they see overmethylation in cancer patients with SAM over 300; only in metastatic cancer patients. They have never seen it in CFS, autism, or any other disease.
  • Folinic acid goes across the blood brain barrier very quickly which is an advantage.
  • MSH of 35 or above is good. Dr. Nathan mentioned 75 or higher even better.
  • LabCorp is not a good option for testing VIP anymore unless sent on dry ice to ARUP Lab. HDRI can do VIP now as well.
  • Dr. Walker mentioned that LDN at night may help to improve MSH. 

 All in all, it was an amazing day with a talented and bright group of doctors.  The team at Gordon Medical is truly exceptional in my opinion.

Disclaimer: While I attempted to accurately represent the statements of the various speakers, it is possible that the above contains errors or inaccuracies. If you have any corrections to the content listed above, please Contact Me.


  BetterHealthGuy.com is intended to share my personal experience in recovering from my own chronic illness.  Information presented is based on my journey working with my doctors and other practitioners as well as things I have learned from conferences and other helpful resources.  As always, any medical decisions should be made only with the guidance of your own personal medical authority.  Everyone is unique and what may be right for me may not be right for others.   


  Was this helpful?  If you found this information helpful, I would very much appreciate your support in keeping the site going.  If you would like to donate to my work, I thank you in advance and send you my gratitude.