Undiagnosed Infections Are Silently Causing Chronic Disease with Dr. Richard Horowitz

Mark Hyman, MD

Full Transcript

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Dr. Richard Horowitz
At this point, like you, I've seen over thirteen thousand chronically ill patients who've been to thirty, forty doctors, the most was a 100 by the way, who ended up getting better. The key six root causes that I was finding is number one, infections. A bacterial infections like Lyme, but also one that a lot of people don't know about, is Bartonella.

Dr. Mark Hyman
What you're saying here is that all of these have similar underlying causes. Correct. And if you treat those underlying causes, the downstream effects tend to get better without treating them directly.

Dr. Richard Horowitz
Correct. And that's the problem in medicine. The way we were taught is name the disease, throw the drug at it. But you didn't get to the root causes of why they were sick.

Dr. Mark Hyman
Alright. Doctor Horowitz, Richard, so good to have you on the podcast. We were just chatting a little bit, and we've known each other for more than two decades, and we have shared so many patients together. And you and I are those kinds of doctors that people go to after they've seen everybody. Like, I used to work at Canyon Ranch, and my joke was it was a health resort, and I was the doctor of last resort.

I'm resort That's exactly doctor.

Dr. Richard Horowitz
That's exactly what they would call me as the doctor of last resort.

Dr. Mark Hyman
Resort doctor. Yeah. And so I think I think, you know, we're gonna talk about this chronic disease epidemic. You recently wrote a book called ending chronic illness, which is a really important book. We've come to all the same conclusion.

Anybody who's really seriously looking at chronic disease, who's looking at root causes, who's trying to understand the body, who's seen 10,000 plus patients, knows that what we thought in medical school was not the right map for the body, And that so many of our chronic diseases have very similar underlying root causes, and need a very different approach to address the dysfunction dysfunctions we see in people. And so your book is really kind of a road map on how to do that, which is amazing. So many people are struggling, and they suffer, and they don't need to suffer. Maybe you can kind of take us back to how you're kind of a regular doc, and you know, you got trained traditional medicine like I did. When did when did you go, wait a minute.

I think we're missing something here. When was that moment for you when you're like, wait, shit. This isn't the whole story.

Dr. Richard Horowitz
For me, what was kind of interesting, it was it was almost a spiritual path because I did my medical training in Belgium and French for seven years, and I started studying with Tibetan Buddhist lamas in 1981. Oh. And when I was leaving I don't know if you knew the story.

Dr. Mark Hyman
I do. Do. I yeah. I you know, we talked about this. I actually majored in Buddhism in college.

Uh-huh. And Tibetan Buddhism was the same thing.

Dr. Richard Horowitz
So yeah. So you know, I'm leaving medical school, and I go to my Tibetan teacher, and I go to Lama again, and I say, Lama, what's the most important thing you want me to know as a doc? And he said, Richard, the most important thing is put yourself in people's shoes and do for them what you would want done for yourself. They call it exchanging yourself with others. Basic advice, you know, love, wanting other people to be happy, compassion, wanting other people to be free from suffering.

Yeah. So here I moved to the Hudson Valley, New York after being at Mount Sinai, getting my internal medicine residency,

Dr. Mark Hyman
and

Dr. Richard Horowitz
board certified. And I move into the largest Lyme endemic area in The United States, which is where the Tibetan monastery was for me to continue practicing meditation. Here these Lyme patients are coming in, this is going back now to 1987. They're coming in, they're coming in with bull's eye rashes, nobody knows exactly what to do. I start a medical detective journey of like why these people are sick, because I sent them to neurologists and rheumatologists and infection, nobody knew what to do.

Especially because the infectious disease doctors thought, you know, thirty days of antibiotics, that's it, except they kept coming back sick. So I started on this journey and ultimately functional medicine came in because as I was discovering root causes of why they were sick, and I'll give you some examples. This woman in a wheelchair comes in, this is early on. She can't walk, she's in a wheelchair for five years, and she's sweating bullish. She's got drenching night sweats.

I just got back from a line conference and learned about Babesia, this malaria like parasite.

Dr. Mark Hyman
Yeah.

Dr. Richard Horowitz
It's not supposed to be in the Hudson Valley. I test her for it, I test the ticks, it's positive. I give her Mepron Azithromax, which I published at the conference the year before, and lo and behold, she starts walking out of a wheelchair after five years, and she was on five years of antibiotics for chronic Lyme. It wasn't until the parasite got treated, another patient then comes in shortly afterwards, she can't speak, she's got dysarthria, I found out it was Bartonella, it was another bacteria. She went to a very famous Boston hospital, said it was a migraine, I treat the Bartonella, she talks for the first time.

Wow. So one by one what started happening is I started discovering these pieces to the puzzle, and mold toxicity started showing up shortly afterwards where these people were getting better from the protocols I've developed for Lyme, but still something was off, and I started discovering other viral infections, long COVID patients were relapsing with Epstein Barr and herpes virus six, they had candida overgrowth in the gut, they were loaded with heavy metals on top of mold, The microbiome was off. They had leaky gut and intestinal hyperpermeability. So one by one Yeah. As these sick patients were coming in, I started discovering these pieces of the puzzle, and that's how the 16 Epsom's model came to be.

Dr. Mark Hyman
I I don't know if you know this about me, but I was one of those patients. Like, really, I was 36. I was really healthy the year before, riding my bike a 100 miles a day for three days from Boston, New York on an like an AIDS ride. And I could, you know, remember 30 patients the end of day with no problem, and I went from one day to the next, just My whole system collapsed. And it was a very long period of recovery, but I ended up having heavy metal poisoning from mercury from living in China.

My gut went crazy, I had leaky gut, I developed bacterial overgrowth, my belly was just bloated, like I couldn't even eat anything. I had severe cognitive impairment. I couldn't sleep. My muscles were aching. My muscle and glands were like 600.

My autoimmune antibodies were high. My white count was low. I had all these like weird things going on. I ended up having Lyme disease, Babesia. I lived in a 1825 building in a house that was There was the mold.

With the mold in the basement. I remember it was like so moldy. And I had everything. I had heavy metal, I had mold, I had tick infections, I had gut issues, All of it. And my hormones started going wacky.

My mitochondria went wacky. And all the things that you describe in your book, I experienced as a patient. I only discovered all this because I was desperate to get better for myself. Right. And I started treating me with with my own, with what I learned from functional and systems medicine, and I started getting better.

And I started treating my patients, and they started getting better. And I was I was flabbergasted. Like, you did what and you got better? You just changed your diet and you did this or you did that and your, you know, your your migraines are gone, or your arthritis is gone, or like I was like, sort of stunned as a traditionally trained doctor that these things were working

Dr. Richard Horowitz
because No. And and I had the same experience. I came on with allergies and asthma. Yeah. My father was a surgeon.

Every time I was sick, it was like, Harris, give him a shot. Nobody used probiotics right at that point. I had candida overgrowth in my gut with leaky gut with mast cell activation until I figured out I had to get off histamine foods, my asthma wouldn't go away. It was interesting, I went to Yeshe Dandan, the Dalai Lama's personal physician Oh, at one my God. Because of this connection.

He takes my pulse and he goes, oh, trauma at six years old caused asthma. I went, oh my god. My parents got divorced at

Dr. Mark Hyman
Seriously.

Dr. Richard Horowitz
You know, the type of

Dr. Mark Hyman
experience I got it.

Dr. Richard Horowitz
So the type of experience you had, I also had leaky gut intestinal hyperbilium. Metals. I chelated myself for metals for a year and a half. I think the doctors, by the way, like us who do this, who've had the personal experiences, they probably have more compassion for the patients because they've been through this themselves.

Dr. Mark Hyman
Well, because because these are the patients that the joke in medical school was they have a supratentorial illness, which means it's all in their head. It's like a big fancy word for how doctors sort of basically are pretty, you know, derisive about patients and cynical. And they think that, oh, people are complaining of all these weird and vague things. I didn't really learn about it in medical school, so it's not really real. But it is, and people suffer tremendously.

And that's what drives me so much in my work, and I know you too. You work tirelessly, and I used to know invasions. You've written all these books too. And your last book was Why Can't I Get Better, and How Can I Get Better, which was great? So you you've really been on this path a long time.

And what I wanna do is sort of get into the details of it because I think people listening really need to understand, like, what are the root causes? And then you came up with six things, and they're very it's a very similar thing we come up with in functional medicine. One of the downstream effects. And at the end of the day, a lot of the suffering that we're seeing in chronic disease is inflammation. And there are many roads to get to inflammation, whether it's metals or mold or ticks or gut or food sensitivities or whatever the list is.

But the end result is it has harmful effects across every system of the body. So let's talk about, like, what are those six principal causes of inflammation that you described, and how how how do you start thinking about digging around being a medical detective? Because that ultimately, you'd be really good at finding these things. Yes. Which, by the way, are things that traditional doctors never look for.

Dr. Richard Horowitz
At this point, like you, I've seen over 13,000 chronically ill patients who've been to thirty, forty doctors, the most was a 100 by the way, who ended up getting better. The key six root causes that I was finding is number one, infections, a bacterial infections like Lyme, but also one that a lot of people don't know about, which is Bartonella. Now there are 18 to 19 different subspecies of Bartonella, so if you try going to LabCorp Quest to get a Bartonella test, you're gonna miss it. Right? And a lot of these long COVID patients who come in with VEGF, with vascular endothelial growth factor, it's not from spike proteins that are actually inflaming the end the endovascular air shoe, it's basically Bartonella.

So, you know, we find Bartonella in a lot of these patients, which drives inflammation. Reactivated virus is definitely Epstein Barr herpes virus six, especially in the long COVID population. Parasites like Babesia, very common at this point. And Candida, so it's you know, it's basically bacteria, viruses, fungi, and parasites. But the second is the environmental toxins.

Dr. Mark Hyman
Before we jump to that, I wanna kinda dive in, because a lot of people say, I went to the doctor, I got my test done, you implied that, you know, they miss it. How do you get people tested? What are the ways that people should think about finding out these things about themselves and these infections?

Dr. Richard Horowitz
If I want to check for Lyme and Bart, I'll go straight to an iGenx immunoblot. Their IgM IgG immunoblot, and Bartonella IgM IgG immunoblot, Bartonella fish, which tags for all these different species, or even TLAB, very good Bartonella fish, Babesia fish. They even do a good Lyme PCR. Mhmm. So I like these specialty labs.

It's not that I can't use the local labs with an ELISA or Western blot, but I find these specialty labs are really needed. I I play a game with people called Lyme bingo, which means that if you come in and you're tired and you're achy and you have brain fog and you can't fall asleep and you keep waking up and you're depressed and you're anxious and you have chest pain and shortness of breath, right, all the multi systemic symptoms of Lyme. Even if you go to a local lab and you get back one Borrelia specific band on a western blot, 23 outer surface protein c, 31 outer surface protein a, 34 outer surface protein b, 39 very specific, eighty three ninety three. Now the 31 is a little nonspecific of Epstein Barr autoimmune, but if you come in with a disease with good and bad days, where the symptoms come and go with migratory pain, and here's the key, Lyme patients have migratory joint pain, migratory muscle pain, and migratory nerve pain, tingling, numbness, burning, stabbing vibration. The hallmark of Lyme is migratory pain.

Yeah. So if you have migratory pain It around. Moves around your body, you can't explain why.

Dr. Mark Hyman
Yeah. Yeah.

Dr. Richard Horowitz
And if you have that with even one of these bands that I mentioned on an immunoblot, which is recombinant DNA, you've been exposed to a Borrelia species.

Dr. Mark Hyman
So you're saying you need to go to a specialty lab like Hygenx that does testing differently than you'd get at a normal lab like Quest or LabCorp.

Dr. Richard Horowitz
Correct. You can still get a Western blot and an ELISA that But I might miss it. The c six ELISA checks for three strains, Borrelia burgdorferi, Abzellang guerini from Europe, but and even heart tick relapsing fever, Borrelia miyamotoi, which you have a Lyme like illness, you go to the lab, oh, it's negative, but there's a relapsing fever Borrelia, it's like a cousin of Lyme disease. Yeah. It's also showing up in twenty five percent of these patients.

Yeah. So that's why you have to kind of understand, we're in the middle of a tick borne epidemic. Yeah. In the middle of an environmental toxin epidemic. I mean, these infections and toxins together, they're really pushing inflammation.

Dr. Mark Hyman
Don't forget mold. So we'll get to that. Alright. So so we kinda dive into those things, and then the toxins are the next big category. Right?

Tell us about the way in which those are prevalent and how they

Dr. Richard Horowitz
I tested myself early on. A dentist friend of mine tested himself for heavy metals, was loaded. I tested myself loaded on mercury, arsenic, cadmium, aluminum, myself. I chelated myself for a year and a half to pull them out.

Dr. Mark Hyman
With DMSA?

Dr. Richard Horowitz
With DMSA, generally. And then afterwards, we had mold in our house like most people do, right, exposed, and I started looking for patients. So it's the same thing, I found it on myself, started looking for others, and I didn't realize at the time how important mold was. Mold is a mitochondrial poison, and mold affects your immune system. So here's the problem, you get Lyme and Bartonella, which causes immune deficiency, you get so it destroys your B cells from the bone marrow that make antibodies.

Twenty percent of my patients come in with chronic variable immune deficiency, eighty five percent subclass deficiency. You can't fight infections if you have immune deficiency.

Dr. Mark Hyman
It's interesting you say that because I I after seeing so many patients with tick infections, it was like I was like, this is kinda like AIDS.

Dr. Richard Horowitz
It is. It just screws

Dr. Mark Hyman
everything Absolutely.

Dr. Richard Horowitz
People don't realize how badly this affects.

Dr. Mark Hyman
It's it's it'll die from it, it screws everything.

Dr. Richard Horowitz
They get COVID with t cell exhaustion on top of your b cells. Right? So now you can't your natural killer cells were thrown off. You can't fight viruses and cancer the same way, and they get mold toxins with gliotoxins on top of it which are immunosuppressive. How can you expect people to get better when their immune system is so profoundly affected by this?

So yes, the mold toxins in heavy metals on top of these other infections, they're really important to go after, and I found that the majority of the chronically ill patients where inflammation was driving their illness, it was absolutely the mold, the metals, and these infections at the top of the list of what I call the six rivers of inflammation, which is in ending chronic illness.

Dr. Mark Hyman
In your book, chronic illness, you you do talk about how it's not just one thing. Like, it's this thing stack. It's like everybody has everything almost. To some degree, it's all a whole system collapse, and it's triggered by and everybody's a little different. Some of have more molds, more ticks, some more metal, but it's usually a combination of the load of everything that just causes this system breakdown.

Dr. Richard Horowitz
Absolutely. And and in fact, my wife, Lee, my my beloved, had all 16 of these M SIDS factors that I'm describing, but as an example, we didn't know at the time she had leaky gut, intestinal, and she had mast cell activation. So she's thinking, oh, bone broth is good for me, and I had some chalk the night before, and a little bit of kimchi with some fermented vegetables. She wakes up the next morning vomiting on the floor with a migraine. Yeah.

And I didn't and I said, what did you eat? She told me and I went, oh my god, sweetheart, you have mast cell activation. We got her off the histamine foods, she has not had a migraine since. That's Now, my Sicilian mother-in-law may have played some role in that, that's a separate issue with stress, but the point is, it was the histamine sensitivity. Yeah.

Right? So each time I pulled a nail, I treated the Lyme, she got better. It's like peeling an onion in these people. Right? So, yes, the leaky gut and the microbiome issues.

Also, we now with the gut brain access, what we know about the microbiome, in every

Dr. Mark Hyman
That's the other main trigger you're talking about,

Dr. Richard Horowitz
the Yeah. I mean, the interesting part about every disease I looked at, from ADD, ADHD, to autism, to Alzheimer's, to allergies and asthma, to cancer, cardiovascular disease, chronic fatigue syndrome, fibromyalgia, digestive disorders, irritable bowel, inflammatory bowel, immune disorders, autoimmune disorders, rheumatoid arthritis, MS, mood disorders, depression, anxiety, OCD, psychosis, bipolar, all 16 M SIDS factors showed up in all these diseases, and my wife is one example. I had to go after every one of these, and now she's in perfect. She's eight years in remission since she did the dapsone protocol for Lyme. It's a nine week oral protocol, and she's eight years in remission without one symptom.

Dr. Mark Hyman
That's incredible.

Dr. Richard Horowitz
But she's gotta be strict with her diet. Right? Staying off candida, hypoglycemic diet, we both share similar, like, blood sugar swings if we're not careful with our diets.

Dr. Mark Hyman
I mean, it's it's so true. It's like, you know, you have to go systematically through everything, and it's not what we're trained to do. We're trained to the model that you talked about in your book, which is a single disease, with a single label, with a single drug. And that's just not how the body works. No.

It's just not.

Dr. Richard Horowitz
No. And you know what's really sad for Pete, the number of people I think you've seen this too. The number of people misdiagnosed, they would come in with MS, right, because they had demyelination and tingling numbness, they had optic neuritis, their bladder wasn't working, except they were given the ABC drugs, Avonex, Betaserin, Copaxone, Rebif, God forbid Rituximab, their B cells were gone, they weren't getting better. So it's not a question of do you have MS, it's a question of where's the demyelination coming from, right? In these patients we would find chlamydia pneumonia, Bartonella, Lyme, mold, heavy metals, mercury lead, arsenic, microbiome, and when we treated these things, the demyelination got better, and that's why the drugs weren't working.

And I found with a lot of these autoimmune illnesses, I I had a patient recently with rheumatoid arthritis, true rheumatoid, CCP positive rheumatoid factor, but he had migratory joint pain. So that's why the methotrexate wasn't working, is we had to treat his Lyme, and he had drenching night sweats, he was like 40, and I said, oh, you're in menopause. He he didn't get the joke initially, but it's like it was babesia, of course. Right? Treated it, and now the autoimmune disease was much better.

So he had a true autoimmune illness, but then I have these other people, and you said it before, these autoimmune markers Yeah. They're showing up. The Lyme is causing antidoponergic antibodies, antithyroid antibodies, anticardiolipin antibodies, anti myelin antibodies. It's causing this auto so people come in with these autoimmune illnesses, but it's Lyme causing molecular mimicry. Your immune system is attacking the bug, right, the flagellar, and it's causing these auto antibodies.

It's not an autoimmune illness. It's the bacteria and the toxins that are combining to cause this type of inflammation.

Dr. Mark Hyman
Just for people listening, when you say Lyme, you mean the whole spectrum of tick infections. Yes. Which is a whole

Dr. Richard Horowitz
which is dozens. Right. It is never Lyme disease anymore. I I call it the three b's, Borrelia, Babesia, Bartonella. That's one of the chapters in the book.

Because these three are showing up in the vast majority of So people

Dr. Mark Hyman
at this so the microbiome stuff is a big thing too, and leaky gut and food sensitivities.

Dr. Richard Horowitz
What did you and I know about choking fatty acid bacteria years ago, right, driving inflammation? I mean, I take prebiotics, probiotics, and postbiotics every because I found out that the microbiome is so important. From everything from autism to Alzheimer's to autoimmune right? You can't get around it at this point because of the gut brain axis. So, you know, that's how I support my health.

I, you know, do prebiotics and all of this every day.

Dr. Mark Hyman
You gotta feed your you're you're not just eating for you, you're eating for your microbiome. Yes. Yes. Of course. You know, you you also said something in this long list of litany of diseases, which I think is worth doubling down on, which is all these conditions seem like separate diseases.

They all have separate specialties. They all have separate experts that have to manage each one with all their separate cocktail of drugs. What you're saying here is that all of these have similar underlying causes. And if you treat those underlying causes, the downstream effects tend to get better without treating them directly. Correct.

So That's a big hover.

Dr. Richard Horowitz
And and that's the problem in medicine. The way we were taught is name the disease, throw the drug at it, but you didn't get to the root causes of why they were sick.

Dr. Mark Hyman
Yeah.

Dr. Richard Horowitz
You know, even in autism, I I recently had a young patient, 12 years old, the mother had congenital Lyme and no one ever checked.

Dr. Mark Hyman
Yeah.

Dr. Richard Horowitz
And the boy was living in a very mold toxic environment. So this kid at 12 years old, social problems connecting, right, we gave him dapsone combination therapy for treating the Lyme, treating the BART, pulled out the mole. The kid's brain woke up. Now, the kid had been sick for twelve years and everyone had given up with him, you know, regarding that he had autism, there was nothing we could do. So, you know, we clearly need randomized multicenter trials and all of these things.

There's no doubt. These are these are all, you know, anecdotal stories. But this what the medicine says, what the science says, with over 2,000 references, by the way, you know, in ending chronic illness, is there are 16 factors underlying all of these illnesses. So no matter what you're calling the illness, if you're tired, if you're achy, if you have pain, if you have brain fog, if you have mood disorders, you can't just take SSRIs and say, right, I mean you know Bobby Kennedy Junior's going after it right now with it to get people off of them. But if you have Lyme and Bartonella driving your illness with your mood disorder and mold, it's not gonna be enough.

You've got to get to these root causes and even trauma. I mean, I have to do vague limbic retraining. You probably do this the same. We find that probably at least a third of our population has such severe trauma that even if I address these other causes of inflammation, if I don't do limbic retraining with the Annie Hopper dynamic neural retraining, or primal trust, or Gupta amygdala insular retraining, using the Apollo Neuro, or the Neuropod, getting their vagal system and everything in order, they will not get better. Right?

It's it's like

Dr. Mark Hyman
It's resetting the neur autonomic nervous

Dr. Richard Horowitz
You've gotta reset the autonomic nervous system. It's so that's why all of these 16 points are so important in these patients.

Dr. Mark Hyman
And all the things you're talking about, all these diseases, whether it's dementia or autism or depression or heart disease or cancer or any of these chronic fatigue syndrome, all these things, they're all tied to inflammation. So autism is inflammation of the brain. Alzheimer's is inflammation of the brain. I wrote an article years ago basically about how, you know, autism and Alzheimer's are very similar. If you look at these patients, they have a very similar profile of genes.

They have very similar biomarkers that are abnormal. They have, like, various different manifestations, but it's very it's very interesting.

Dr. Richard Horowitz
It's funny you say that because I just did a medical detective substack on it. Mhmm. The mTOR pathway, right, where we're using people using rapamycin and other things to get to it, it turns out that with autism and Alzheimer's, it's the same biochemical pathway. Yeah. Right?

So they just don't have enough autophagy, they're not getting rid of their damaged mitochondria, they've got an ongoing inflammatory response. And if you give sulforaphane glucosinolate, broccoli seed extract to the autistic population, they did it at John Hopkins, out of third of these kids their brains work. And the same thing with the Alzheimer's. So you're right. Autism and Alzheimer's on a spectrum of brain of neuroinflammation.

Yeah.

Dr. Mark Hyman
All neuroinflammation.

Dr. Richard Horowitz
So instead of naming it, right, where is the inflammation coming from? And that's the whole point of ENT Chronicles.

Dr. Mark Hyman
Yeah. Think that's what Sid Baker talks about, the naming and blaming game. We name the disease, and then we blame the name for the problem. Well, the reason you have joint pain is because you have rheumatoid arthritis. No.

That's just a name that we give to people who have that kind of joint pain. It doesn't mean anything about the cause. It could be mold. It could be metal. It could be Lyme.

It could be a million things, the leaky gut. You also talk about one of the factors being vitamin and mineral or nutritional deficiencies. Can you talk about that? Because people think Sure. We know we're you know, we don't have malnutrition in this country, and we're all eating plenty of food, and what the big No.

Dr. Richard Horowitz
In the top six root causes of inflammation, what I call the rivers of inflammation going into an ocean of inflammation, number five is vitamin mineral deficiencies. And what we're finding because of all the toxin loads, is when you do not just serum minerals, and you know this well, I'll check magnesium, you need it for 300 detoxification enzymes, you need copper for superoxide dismutase, I need zinc for phase one liver functions and inflammation. When we look intracellularly at the red blood cell zinc, the red blood cell copper, the red blood cell magnesium, we're finding up to twenty percent of our patients are deficient, which means you cannot detoxify properly and deal with inflammation. So somebody may have, for example, a normal or slightly low b 12 level, but their methylmalonic acid level is high. So, yeah, we're we're finding a huge amount of vitamin mineral deficiencies and a lot of this is because you're fighting these infections, you're dealing with all these toxins, you're depleting your system including depleting glutathione.

I don't know if you knew this, but I wrote the first article in the world literature in COVID nineteen in April 2020 on glutathione and how it helps with COVID and what I didn't know at the time, not one of my patients died from COVID nineteen, not one, because I was blocking the first major inflammatory pathway I discuss in the book, NF kappa b. We were giving all of our patients N acetylcysteine, alpha lipoic acid, glutathione. I didn't know at the time that the virus needs to lower glutathione to replicate.

Dr. Mark Hyman
Oh, amazing.

Dr. Richard Horowitz
And I also didn't know that NAC was blocking von Willebrand factor, they weren't getting micro clots and dying from it. Yeah. So I was giving them the right treatment, I just didn't know why at the time. Yeah. And then we were stimulating the Nrf two pathway, opening up detox using curcumin turmeric, broccoli seed extract, resveratrol, green tea.

By simply doing these things with a little bit of vitamin D, you know, some extra zinc, I was giving them immunotics, three six beta glucan. By simply doing these things with a little bit of low dose naltrexone, one of my favorites also, for blocking the third pathway, NLRP three inflammasomes, not one patient died and only two were in the hospital. And I saw very few long COVID cases in my practice with

Dr. Mark Hyman
it. Yeah. It's true. I mean, it's it's the the nutritional deficiencies are quite significant, and and I think, you know, with Function Help, a company I co founded, we're doing you know, now we have I don't know. We've over half a million half a million members.

We've done over a 100,000,000 lab tests. Mhmm. Seventy percent of people are deficient in one or more nutrient, not at the level you or I would think would be okay, but at the level the lab reference range thinks is okay. Like a vitamin d of thirty, or ferritin of sixteen, or homocysteine of, like, fourteen or like so, like, the the numbers that are even greater than that when you look at what the optimal ranges are is staggering. And vitamin D, you know, should be over 45, and then thirty is their cutoff.

So all the all within their cutoffs on the lab, we're still seeing about seventy percent of people deficient in one or more nutrients. So you're right. These nutrient deficiencies are so important, and people don't understand that what they do is they they basically keep the wheels of your biochemistry working. And if if if it's if they're not adequate, then the system can't run. And you get, you know, kind of like kind of rusting.

Things just kind of locked down. The last thing you kind of talk about in in your six principles is sleep. But I'm I'm wondering why you focus on sleep versus stress. Because I think I think of stress and sleeping under stress. Right.

But you you focus just on sleep.

Dr. Richard Horowitz
So it's interesting that I also found with sleep, same thing, the 16 same M SIDS factors are underlying sleep. But in my population of Lyme, these people don't fall asleep. It takes hours to fall asleep, they keep waking up in the middle of the night, they sometimes have hypersomnolence, they're sleeping for sixteen hours, they're not refreshed. I have patients who came in on Ambien, Lunesta, God knows what, they still could not sleep. So I mean you know when you don't sleep, IL six, interleukin six is high, it's driving inflammation.

But ultimately we were even finding some of our thin young women had sleep apnea, like something I would never have expected to find. It wasn't just men with BPH, you know, that was causing it. It wasn't just menopause with low estrogen. We were finding multiple factors, and of course stress is one of them, of course. But the problem is we were finding these overlapping factors that until I treated the Lyme and the Bart and the mold and healed the microbiome, right, and dealt with stress and I have a whole section under Ellis for Lifestyle and Meditation, I mean you and I both know we're living very stressful lifestyles for most people.

The sleep I found that when people couldn't sleep, whether I treated the infections, I detoxed the mold, If the sleep was still off, was having a tough time getting these patients better. But they were all interrelated, right, because the mold was causing problems with it. The Lyman Bartonella was causing

Dr. Mark Hyman
He was asleep.

Dr. Richard Horowitz
Yeah. So it it it was all interrelated. It wasn't just, oh, I can't sleep at night. You know, why isn't Myambian or Lunessa working at this point in time?

Dr. Mark Hyman
So you're able to get people who couldn't sleep back to sleeping?

Dr. Richard Horowitz
Yes. Yeah. I mean, once the infections were treated, we detoxed the mold, the microbiome was treated, right, the mineral deficiencies. Once we started dealing with these first six rivers of inflammation, people were able to get to sleep a lot easier. Also, by the way, with the limbic vagal retraining.

Yeah. Right? I mean, that that was a key point in these people because

Dr. Mark Hyman
I don't wanna get too far into it, but I think, you know, I I did ibogaine. I talked about it on the on the show before. It's a you know, it's an incredible plant medicine that has powerful effects on neuroinflammation and on mitochondria and epigenetics. And in in one study, they they looked at MS, and they looked at the white matter lesions, which is inflammation in the brain before and after Ibogaine and their and their symptom profile. And they were there were only two cases in that report, but they both had, like, a seventy percent reduction in white matter lesions, which is unheard of, and they were able to get back to much more normal functioning.

So I think, you know, there's a lot of really ways to sort of reset the system. It's it's fascinating that, you know, these these plants and these other things, like some the supplements can have these effects.

Dr. Richard Horowitz
Oh, absolutely. And in fact, I recently published an article in the Journal of Alzheimer's Disease Reports, we can get into this just briefly about

Dr. Mark Hyman
Yeah, I wanna get it.

Dr. Richard Horowitz
I reversed for the first time ever in the world, the most sensitive and specific biomarker for Alzheimer's, p tau two seventeen. So again, we're dealing with neuro inflammation, but where did it come from? In my patient, it was coming from multiple M SIDS factors. It was Lyme, she had exposure to Babesia Bartonella, she had heavy metals, she had metabolic syndrome, she had food allergies. We need to treat it all, but interestingly enough, we were finding that when we treated the Lyme disease with the nine weeks of dapsone combination therapy, she was sick for fifteen years by the way, with positive rheumatoid factors, with joint pain, some cognitive issues which she didn't think were bad, completely reversed p tau two seventeen.

Now what's interesting is that the Cochrane report, which came out about one week before my article got released, said, hey, we have no good things to treat Alzheimer's at this point. The article comes out one week later, and what I did is I proved the hypothesis. Right? We're in the middle of an Alzheimer's epidemic where the NIH said that forty two percent of people over 55 years old are now gonna become demented. Right.

I mean, it is really frightening, especially when they say we don't have answers. So there was always they looked at autopsy studies of Alzheimer's patients and they would find biofilms, amyloid, and phosphorylated tau in the brains. So there was an association, but they couldn't say causation. This is the first time I proved causation by completely reversing this biomarker p tau two seventeen with this nine week pro and this woman was, by the way, was sick for fifteen years.

Dr. Mark Hyman
And the symptoms got better.

Dr. Richard Horowitz
Her symptoms her joint pain got better, rheumatoid factor reversed, because it wasn't rheumatoid arthritis. It was from the Lyme bacteria driving rheumatoid factors.

Dr. Mark Hyman
What about her memory, did it get better?

Dr. Richard Horowitz
It also improved. She thought it was her meditation that was keeping her stable, and she noticed after she was done, it's like, oh my God, I'm so much clearer. By the way, I have a second patient, I just did the same, I haven't published it yet. We reversed his beta amyloid ratios with dapsone. So here we have an Alzheimer's epidemic where I found that all 16 M SIDS factors are associated with it, the Cochrane report is saying, hey, we don't have anything good out there to treat, And the drugs that are used for it, lucanumab, dananemab, they lowered phosphorylated tau by 23% in almost seven years.

I lowered it by 63% in nine weeks. Yeah. And that was because it was the infection driving the amyloid and the phosphorylated tau. And unfortunately, you go to a neurologist, they're not even gonna check you for Lyme disease or Bartonella or mold when you have Alzheimer's disease.

Dr. Mark Hyman
It's important to find out. I mean, people people think, you know, Alzheimer's is one of those things with nothing to do for it because of the bad drug, you know, debacle we have in terms of poor drugs and and drugs that don't really work based on billions of dollars of research and hundreds and hundreds of studies. But but what you're saying is using this approach, which is looking at root causes, looking at treating the whole system, peeling all the layers of the onion, you can actually start to see changes in these people. And I've I've seen the same thing in my practice, and Dale Bredesen, who's quoting a quote on your book also, has done this. And, you know, for for us out there doing it, we we sound a little bit like quacks because, well, why?

We're reversing Alzheimer's. Well, it isn't really Alzheimer's is just a a symptom.

Dr. Richard Horowitz
It's a neuroinflammation.

Dr. Mark Hyman
And and so if you can reduce the the load on the brain, it it can improve. Same thing with autism or ADD or depression. You know? And Chris Palmer's done this work at Harvard with schizophrenia, psychosis, bipolar disease. It's a trial published, I think the other day on ketogenic diets.

It was a randomized controlled trial for bipolar one and schizophrenia and psychosis showing reversal. So the data is really starting to emerge around this, and ketogenic diets work by reducing brain inflammation. That's how they work. Your work is so important on this. I think that I I want to kind of double down on on what you've been kind of alluding to, which is this dapsone protocol.

Because it's you you mentioned a few times, Julian, what are you talking about? And what is it what does this do? And how does it reverse Lyme? How does it reverse Alzheimer's? Like, it's tell us about what it is, how you discover.

Because you and I worked here with many patients, and often I would say, hey. I got this complicated patient with these three ticks or this thing. What's the best drug protocol? And you kind of coached me through it. That's probably started that doing that twenty five years ago.

But this is kind of a newer iteration of your thinking on this, because I I think a lot of the you're you're a part of the Allied Society, and

Dr. Richard Horowitz
I I was one of the founding members of members.

Dr. Mark Hyman
And, you know, you and I have both seen people who've just been on years of antibiotics, on IV antibiotics, heavy doses, and they and often, they don't really get that much better. And I I really worry about that approach.

Dr. Richard Horowitz
Yeah. No. I and I do too, by the way. So and that's why I never use long term antibiotics anymore. The real key point for me is about ten years ago, John Hopkins researchers found out that Lyme was a specific type of a bacteria called a biofilm persister bacteria, like tuberculosis and leprosy.

We knew that Lyme persisted, at least those of us who've been treating it for a long time, because there's a lot of medical controversies, but it's definitely a persistent infection in many.

Dr. Mark Hyman
I mean, meaning the the traditional medical establishment doesn't quite buy chronic Lyme disease.

Dr. Richard Horowitz
Correct. They call it post treatment Lyme disease syndrome. We don't know why people are sick. It's like, you should read the 10 articles at this point. Well, 10 I published and one by Tufts, where we've shown reversal of all of these symptoms using dapsone combination therapy.

So how did I come up with it? So when Hopkins discovered it was a biofilm persister drug, I remembered from Mount Sinai when I was this was during the HIV epidemic. We would see these people come in with mycobacterium avium intracellulareum TB. I was used to using INH, rifampin, pyrazinamide, and I said, you know, I wanted an excuse to use these TB type drugs because they were specific for biofilm persister bacteria. I looked at the qualities of dapsone.

Dr. Mark Hyman
So tuberculosis is one that's known in traditional medicine to be this, and that's why we use those drugs.

Dr. Richard Horowitz
Absolutely. So I looked at dapsone, it was, alright, it gets great penetration into the brain. Maybe I don't have to use IV drugs, which is true. I've never had to use IV drugs anymore since dapsone. It's amazing penetration in the brain.

Number two, it blocks NLRP three inflammasomes in the brain. So with Alzheimer's disease and autism and many of these different diseases, we know that there's an inflammatory pathway in the brain that gets switched on. Dapsone is an inflammasome inhibitor. So in a study by Lee et al with like three to 4,000 people over sixteen years, he gave him a hundred milligrams of Dapsone. The rates of Alzheimer's were like this and the people who didn't take Dapsone was six times higher.

So it's lowering inflammation in the brain, great penetration, it has antimalarial properties, it hits Babesia, not great, but about twenty five percent of the cases. It's used for autoimmune diseases, we talked about all the autoimmune manifestations of Lyme. Right? And it's a biofilm persister drug, so it checked all the boxes. So I started trying it and I published my first article 2016 on a 100 patients on low dose Dapsone.

Fatigue got better, joint pain got better, neuropathy got better, brain fog, headaches, it was the only thing statistically that didn't improve, but as I tweaked the protocol over the last ten years, I got it down to eight to nine weeks at this point, and it doesn't matter whether you've been sick for twenty, thirty years. If you have Lyme without active Babesia Bartonella, without mold, this protocol will put about half of the people in remission from nine weeks of antibiotics.

Dr. Mark Hyman
And and it's not just dapsone, it's a cocktail.

Dr. Richard Horowitz
It's a cocktail of drugs. So we found and I did a study with Eva Schapi from the University of New Haven in culture.

Dr. Mark Hyman
And by the way, is a drug that was used for leprosy.

Dr. Richard Horowitz
It is a leprosy drug. Right. It's been around for fifty, sixty years. Right. They also use it, by the way, for Behcet's disease and a severe autoimmune illness.

So what I found is in culture, every time we added a drug, like when we added doxycycline to dapsone, it lowered the biofilm persister. We added rifampin to doxy and dapsone, it lowered the biofilm persisters even more, we added Zithromax. I came up with it because we found this four drug regimen sufficiently lowered these biofilm persisters and if you pulse it, you cannot get rid of these persister bacteria by with chronic antibiotics, it doesn't work, You've gotta pulse it. That's how you get rid of them. So we now do a nine week protocol

Dr. Mark Hyman
Which is not every day?

Dr. Richard Horowitz
Well, it's nine weeks continuously, but they're on four probiotics with five hundred billion of these different probiotics twice a day, right, with nystatin, very low carb diet. Don't see I haven't, by the way, seen a case of C. Diff on this in years. No candida as long as you're staying. And basically all the lab abnormalities of anemia and methemoglobin, they reverse within six to eight weeks off the protocol.

So right now I applied for a randomized NIH trial with a double blind placebo multi center trial, unfortunately it was turned down. So I now have to reapply. I know Bobby Kennedy Jr. Is big about Lyme, he wants to do something, but whoever the reviewers were, But I'm so confident I submitted an r 34 NIH grant because I know it's working at this point. But, yes, it's a cocktail of drugs, but the beauty is all generic because I realize this is a worldwide epidemic where BMG Global Health said one out of seven people in the world have now been exposed to Lyme.

Right? So we're we're dealing with a massive epidemic of Lyme, and by the way, same time massive epidemic of Alzheimer's, and nobody has put these two together at this point.

Dr. Mark Hyman
And and that's true. I mean, nobody's connecting the dots on that, but but it's not that Alzheimer's is always this.

Dr. Richard Horowitz
No. No. Of course

Dr. Mark Hyman
it is.

Dr. Richard Horowitz
And I

Dr. Mark Hyman
think that's you you know, you kinda hinted in your book, and I in my first book I wrote, just because you know the name of the disease, it doesn't mean you know what's wrong with you. Right? Alzheimer's is a syndrome Of course. And it's got many causes, and maybe a good cohort of those is ticks, could be mold, could be insulin resistance,

Dr. Richard Horowitz
it could be And look, even some of these drugs that are used out there, the anti amyloid drugs, there may even be a place for them, but first, let's get rid of whatever the reversible causes of inflammation are. That's not what the neurologists are doing. Right? They're giving Aricept and Amenda and anti amyloid drugs. We've got to get to the root causes of where the neuroinflammation is coming from, and that's what I'm highlighting the chronic illness.

Dr. Mark Hyman
Do we all take patients with that same combination? I do. So it doesn't matter what the infection.

Dr. Richard Horowitz
Well, because it

Dr. Mark Hyman
could be before you see this regimen, for this one, this one, that one, now you're saying everybody should get the same

Dr. Richard Horowitz
Well, if it's Bartonella, Bartonella requires a minimum of four two week pulses of Dapsone, but it's only six days of Dapsone. We found with Bartonella, Bartonella's actually much more difficult to treat than Lyme. If you don't have Bart, I can generally get you better much easier within this nine weeks. But Bart requires about two to three months apart, just two weeks of antibiotics, short pulse, actually thirteen days.

Dr. Mark Hyman
Separate.

Dr. Richard Horowitz
Separately. If you have Babesia, meponazithromax isn't working. The old drugs aren't working. So I have in my new book under the three b's, Tefenuquin. Tefenuquin is a newer drug for Babesia.

We mix it with Malarone and herbs like artemisinin, Chinese skullcap, Japanese knotwood, acornia. We find that when we mix these herbs with tofenoquine and malarone, we're getting much better results for Babesia. So you do have to treat some of these infections differently and separately, but the beauty is we do have now some cutting edge approaches that are getting many of the patients better.

Dr. Mark Hyman
And you also use, in addition to the dapsone, doxycycline, minocycline, phampin, hydroxychloroquine, which is

Dr. Richard Horowitz
And the reason for Plaquenil by the way, is it alkalizes the intracellular compartment, so these antibiotics are more effective, helps with the autoimmune manifestations, even hits the cystic forms of Lyme, another form of the bacteria that exists. So it took me a long time looking at the biochemistry of the bug and the science and the biology to figure this out, and ten years later, you know, I've I've published 10 studies, Tufts by the way published one that showed that this combination rifampin dapsone cures Lyme in the animal model. So now I have a culture study, we have animal studies, and I have 10 published studies with around three seventy five patients retrospectively, all statistically significant. Fatigue, brain fog, joint pain, muscle pain, nerve pain, day sweats, night sweats, neuropathy, it all gets better from the protocol.

Dr. Mark Hyman
And you also use methylene blue, which I thought I So tell us about that, because I think people hear about it, and people think, oh, they take these lozenges, their mouth gets blue.

Dr. Richard Horowitz
Well, they're using it for Alzheimer's. Right. Mean, they're using like low dose methylene blue as a mitochondrial supplement for Alzheimer's. So one of the side effects of dapsone is elevated methemoglobin. It's where you don't carry oxygen well in the blood.

So we started adding methylene blue because many of our patients, about ninety percent have Bartonella. John Hopkins again, they published that if you do for six days in culture, rifampin, Zithromax, and methylene blue, it kills Bart. So when I was designing the protocol, I realized I needed methylene blue to not only hit the Bartonella, but to lower the side effects of dapsone. Interesting. And it's got mitochondrial regeneration properties at the same time and we do a mitochondrial regeneration when we're done with the protocol anyway for all the free radical oxidative stress.

So yeah, the methylene blue is an is an integral part of the protocol, and we slowly go up to make sure people tolerate

Dr. Mark Hyman
it. It's also anti infectious.

Dr. Richard Horowitz
It is anti infectious.

Dr. Mark Hyman
And it's

Dr. Richard Horowitz
They use it in the blood supply, by the way, to kill don't if you knew this. No. In the blood plasma supply, when they're treating for all the red blood cells they're storing. Really? Methylane blue is what's used to kill all the infectious agents that's in our blood supply.

Dr. Mark Hyman
Oh, that's fascinating. So it's anti infectious. It protects protects against the side effects of the dapsone, helps mitochondrial function, energy production.

Dr. Richard Horowitz
And it's hitting Bartonella at the same you know, again, I designed it, I was looking at all of these factors at the same point. And again, I've been doing this for forty two years, right, with all these thousand. It took a while to figure this out. Yeah. You know, we're kind of there.

Dr. Mark Hyman
I know. It's pretty pretty crazy. Think it's and you you outline all these protocols in your book. Right?

Dr. Richard Horowitz
So what I do in ending chronic illness, a lot of people I I did it like a cookbook. In in the chapter under the three b's, I do this literally week by week. These are the medications. These are the lab tests you need to do. This is when you need an electrocardiogram to make sure your QT interval is good.

It is written out literally like a cookbook that anyone can take ending chronic illness to their doctor, and they can just do it step by step so they know exactly the protocol. And I I even put in here a low dose dapsone protocol for people that are sensitive because many people get Herxheimer reactions where you're killing off the bacteria. The inflammatory response is huge. I've I told people how to do it much lower and slower for those people who and as an example, my wife, when we didn't know the dosage, we gave her Dapsone fifty milligrams per year, repeated her test, PCR positive in the blood. I gave her a 100 of Dapsone for six months, relapsed within a month or two.

A patient came in, by the way, this is how I discovered the dose, a patient came in who was sick for seven years, came in, he was his third month, fourth month on Dapsone, he comes in and says, doc, I'm feeling terrible. I said, oh, what are you taking? Well, I'm taking know, doxy twice a day, rifampin twice a day, and dapsone twice a day. I said, my god, you're taking too much. You're taking a hundred twice a day.

I said, stop it, come back in a month. He's been sick for seven years. He comes back in a month and goes, doc, I feel great. I have no symptoms. I went, what?

I said, stop. Don't take anything else. Just come back in three months. He comes back in three months, no symptoms. Comes back in six.

So I said to my wife, would you like to be a medical guinea pig? This guy took a double dose of Dapsone, a hundred twice a day for one month, and he doesn't have symptoms.

Dr. Mark Hyman
And he felt sick because of the side effects of it.

Dr. Richard Horowitz
He was herxing badly when he did it. Uh-huh. My wife did it for one month. She's eight years in remission. I had to figure out, it's not long term antibiotics.

It took me years to figure out the dose, and how to combine the medications in a way that it was a very short term effect or protocol, and my wife was one of the first people actually who got better

Dr. Mark Hyman
from it. That's quite amazing. That's quite amazing. Again, I've been following you for a long time and tracking all the different iterations of your thinking, and this is this is definitely an evolution, and it it seems more elegant, and and it answers a lot of the questions that I have around these long term antibiotic patients who just don't get better.

Dr. Richard Horowitz
I I do not too long. I don't believe long term antibiotics should be given to anyone because you know the effect of the microbiome on the gut. Yeah. And it doesn't kill the Lyme. Yeah.

It's suppressing the bacteria. Right? By the way, they've even shown in some of these, get more biofilm formation if if you do this. So we need an entirely new approach which is pulsing short term while supporting the microbiome, and then using these biofilm persister drugs like dapsone. I do believe by the way, even in Alzheimer's because dapsone inhibits this pathway in the brain, NLRP three inflammasomes, I don't know why anyone has not taken dapsone like they did in the study from South Korea.

4,000 people, their Alzheimer's rates were like this, huge low dose dapsone.

Dr. Mark Hyman
They used it for what there?

Dr. Richard Horowitz
They were using for leprosy. But they found when they looked at the Alzheimer's cases, dapsone was stopping people from getting Alzheimer's disease, and it's four thousand people over fifteen years

Dr. Mark Hyman
That's incredible.

Dr. Richard Horowitz
That they looked at this.

Dr. Mark Hyman
That's incredible. Wow. So let's kinda back up. We we talked about all these six principal causes, rivers of inflammation creating an ocean inflammation. Right?

The infections, the toxins, the microbiome, leaky gut, food sensitivities, vitamin mineral deficiencies, and sleep. And then you talk about the 10 downstream secondary effects. And this is really when you have all these insults, and you don't have enough of the right inputs, there's a cascading effect of dysfunction throughout the body that echoes. And it's it's all the systems of the body, and it's basically a network. And all the different ones are connected, hormones, gut, immune, mitochondria, then detox, they're all they're all kind of connected.

And and so this is how we think about things in functional medicine, but it's you came to this through a different pathway and ended up in the same place. And and I'd love you to sort of unpack the sort of the things that tend to go wrong because you can treat those directly, but if you don't treat the root causes, the six rivers, you you those things are you might be able to move the needle a little bit, but they're gonna kinda not really get better.

Dr. Richard Horowitz
Sure. Mean, and as an example, so one of the 10 downstream effects is mitochondrial dysfunction. If you have ongoing inflammation in your body, the mitochondria have nothing to protect them against all this free radical oxidative stress. Right? It's not like the DNA that has histones surrounding it.

So that's why we do a mitochondrial regeneration protocol after we do these treatments. But if you're somebody taking ATP three sixty and CoQ10 and Urolithin A and Mito Nr and the things I'm taking myself because I'm doing my own biohacking. It's not gonna work. You may say, hey, I'm doing everything right. I'm exercising, I'm on a low carb diet, I'm getting enough sleep, I'm doing mitochondria.

Why isn't it working? We didn't get to the first root causes of where the inflammation's coming from. Right? But also in this inflammation, it affects your hormones because the inflammation is affecting the hypothalamic pituitary axis. So men come in with low testosterone in their twenties with a 100 to 200 testosterone, and they're getting beta h e g shots and they're getting, you know, testosterone.

It's like, hold on. It's the Lyme that's causing your low testosterone. Right? And the adrenals are shot. Close to a hundred percent of my patients have low adrenal function on a DHEA cortisol.

And again, if you treat these six rivers of inflammation, but you don't treat the adrenals, they're not gonna get better. Have a I have a person this guy was treating years ago, he was sick for about eight years. We found Lyme Babesia Bart, we started looking for it, and we found low adrenals. And before I even had a chance to treat the Lyme, and this was going through his hospital records, his cortisols were really low. And I said, alright, I'm gonna have to treat all this, but I said, let me give you some hydrocortisone for the I mean, was really low, literally Addisonian type low cortisone.

He said, I don't wanna do it. They gave me prednisone in the hospital. I never wanna take steroids. I gave him an adrenal glandular. Now this guy had multiple M SIDS factors making him sick, Lyme, Babesia, Bart, the rest.

Within a week of taking an adrenal glandular, he said doc, I'm eating 90% better. So personalized precision medicine, you know this the way I do, even if you have eight or nine M SIDS factors on your list, it might be one factor that's keeping you ill. And in a lot of the patients it's adrenal, They do the mitochondrial, but you've gotta definitely get the hormones balanced. But the other downstream effects is immune dysfunction. Many doctors don't check immunoglobulins, subclasses.

They don't check natural killer cells. Yeah. They don't do CD four, CD eight. Well, this is how do you check your immune system? Or they have autoimmune diseases.

Dr. Mark Hyman
People don't really realize that you can actually test your immune system.

Dr. Richard Horowitz
Right. So and same thing. We check the autoimmune markers, one of the downstream effects. Or you get neurological issues with brain fog, you're going from doctor to doctor and understanding why your memory's off. Right, and you've got amyloid and p tau now maybe from other sources, right, or psychological factors, trauma, where you need the limbic retraining, and then you're deconditioned, right, and a lot of people also, and you know this, have fatty liver.

One third of the world's population has nonalcoholic steatohepatitis or fatty liver.

Dr. Mark Hyman
Now they call it metabolic syndrome.

Dr. Richard Horowitz
Metabolic right.

Dr. Mark Hyman
They changed the name because

Dr. Richard Horowitz
they Just like PCOS is now PMOS. Right? It was the same thing.

Dr. Mark Hyman
Metabolic reproductive But

Dr. Richard Horowitz
it causes insulin spikes with metabolic syndrome.

Dr. Mark Hyman
Yeah.

Dr. Richard Horowitz
And it's a silent factor for cirrhosis and for liver cancer. Yeah. And you could go to a doctor with normal lab tests, your liver functions are normal, but you're overweight, the doctor doesn't check an ultrasound and there's the fatty liver. Yeah. We were finding it.

So these 10 downstream effects is, again, the liver, the immune system, autoimmune, mitochondrial, hormonal dysfunction, deconditioning, neurological issues, psychological issues, and pot's dysautonomia. People come in with long COVID to my practice. Right? They're tired. They've tried everything.

Nobody did sitting and standing blood pressure and pulse rates to find out if they had POTS dysautonomia.

Dr. Mark Hyman
Yeah.

Dr. Richard Horowitz
And so POTS dysautonomia is not treated with antibiotics. Right? It's salt fluids. It's midodrine. It's vagal retraining.

It's limiting retraining.

Dr. Mark Hyman
Causes too.

Dr. Richard Horowitz
Because it causes fatigue, brain fog, anxiety, palpitations. Right? Potts dysautonomia has a lot of the same symptoms as Lyman, Bartonella, and mold. So that's why a differential diagnosis is so important in these patients, and dysautonomia shows up in forty to fifty percent of our patients at this point.

Dr. Mark Hyman
I'm gonna I'm gonna push back a little on the differential diagnosis, because that in in medical speak, that's what doctors do is they they they try to winnow down what your story is to one single diagnosis. But you're really talking about a true differential diagnosis, which is thinking through past the diagnosis. Okay. What is actually the root cause? What are the systems that are out of balance?

How do I treat all those, you know, six causes and 10 downstream factors? And, you know, you you come up on the same framework that I have, which is that you have to deal with the root causes, but you have to also deal with the train wreck that happened as a result of those root causes, which is adrenal dysfunction or hormonal dysfunction or gut issues. You have to kinda clean up the mess. It's like, yeah, you have to put the if the train's off the tracks, you gotta fix the tracks, but then the train also went off the tracks and created damage everywhere, so you gotta clean that up. And but if you if you did the cleanup first and you don't deal with the root causes, people tend not to get better.

That's the kind of trick. People go, oh, and a lot of people out there are doing this. They're giving hormones, or they're giving, you know, gut stuff, or they're giving different treatments, but they're not actually getting to the things that matter, like the mole, the tick.

Dr. Richard Horowitz
I was surprised that when men come in in their twenties and thirties with low t and their testosterone is off, for some reason, lot of the doctors didn't know that Lyme and Bartonella sneezing, because of inflammation in the brain, cause low testosterone. And I will give them a little bit of Clomid, Clomiphene, twenty five milligrams two or three times a week with Arimidex to stop aromatization, and I'll get their testosterone from a 100 to 600 without beta h c g, without shots, resetting the hypothalamic pituitary system, getting the hormones back in balance. So, you know, I have all of these tricks in the h's for hormone chapter, you know, in any chronic illness because if you're a man and you wanna have kids growing older, you can't be getting these shot these testosterone shots are shrinking your testicles by 15% and stopping your own hormone production. So yes, it's always about the root causes, but I find that, you know, even the functional medicine community, you see a complex patient that you're with them for hours, the beauty of the 16 m six model, it's a checklist. Right?

It's just make sure you've just gone through these things just to make sure you're not missing anything. Yeah. And I I find, you know, you can get caught up, you know, in these in these very complex patients where you might forget to check the molds or do the adrenals or because the patients are you you're know, the first doctor really listening to them and taking the time to listen to them.

Dr. Mark Hyman
You're right. I mean, it is it is a checklist, and I and I do go through that mental checklist. You know, and I I often have the the echo of Sid Baker, who's my mentor, in my head. He says, have you done everything you can for this patient? Which means, what haven't I thought of?

Mhmm. Like, what am I missing? Like, not what did I find, but actually, what what am I missing? And and when you go hunting, you find stuff. And it may be the thing or may not be the thing, but you you have to actually go hunting.

And I think most doctors don't know how to hunt. They don't know how to hunt for the root cause. They don't know how to test for mold. They don't know how to test for metals. They don't know how to test for ticks.

They don't know how to test for the gut microbiome. They don't know how to test for leaky gut, for food sensitivities. They don't how to test for hormonal dysregulation. The whole gamut of things that you and I deal with every single day with our patients, and that gets these people who are literally incurable cured. It's not rocket science.

It's it's it's just good science.

Dr. Richard Horowitz
But, you know, you've gotta teach doc I I had a mentor just like you did with Sid Baker. My mentor was doctor Rosenek. He was the most brilliant internist I ever met in medical school. He's the one who influenced me like Sid Baker did for you.

Dr. Mark Hyman
Yeah.

Dr. Richard Horowitz
And what he taught me is also to keep getting underneath to the root causes. But what I did in ending chronic illness regarding that is I have starting around page 30, if you have symptoms, like let's say you have neuropathy, and you've been to all these doctors, you're on Lyrica, you're on Gabapentin, and you're on Elavil, you still have neuropathy. Maybe somebody's not checked you for Lyme, and Bartonella, and mold, and heavy metal toxins that cause neuropathy, and what I find is, and I did this in the book, I list the disease, the lab testing for it, and how you do the differential diagnosis so that people can actually work with their healthcare providers so they don't miss anything at this point. And the Harwitz Hemsets questionnaire, which is on my website, cangetbetter.com, if you take this questionnaire, it will give you a probability of tick borne, but also you bring it to your doctor, there's 38 items on there, you might forget to tell your doctor you have drenching night sweats intermittently, which was the babesia, the parasite hiding in the background. So the beauty of the questionnaire is we validated it in 1,600 people.

It's an easy questionnaire to bring to your doctor, so nothing is missed. Right? So that's

Dr. Mark Hyman
why And Is that available in the book and online?

Dr. Richard Horowitz
The questionnaire is in the book as well as these Online. These different it's online also in under cangetbetter.com. You can just download the questionnaire.

Dr. Mark Hyman
Cangetbetter.com.

Dr. Richard Horowitz
Cangetbetter.com.

Dr. Mark Hyman
Yeah. And and, you know, people have been referring to MSIS. What it stands for is multiple systemic

Dr. Richard Horowitz
infectious Just disease

Dr. Mark Hyman
to just to ask about that, what if it's not always infectious? Like, what if what if it's just mold or heavy metal? It may not be Lyme. Right? How how does how do you have the eye in there?

Dr. Richard Horowitz
The way I'd now look at chronic illnesses after finding that these 16 factors are underlying literally autism, Alzheimer's, chronic fatigue, is it you don't have to have Lyme making you ill, absolutely not. But it could be for example, chronic fatigue syndrome, M SIDS, meaning you don't have Lyme that's causing it, but you may have Bartonella, you may have mold. I I was surprised when I did the research on this book. Fibromyalgia, didn't learn in medical school that mold toxin just showing up in seventy to eighty percent of fibromyalgia patients.

Dr. Mark Hyman
Yeah.

Dr. Richard Horowitz
They're they're getting drugs from their doctors for the pain and the without understanding that the mold was driving the inflammation. I didn't know this, by the way, until I did my own research for the book. So these diseases for me are now kind of like Alzheimer's, M SIDS, chronic fatigue, meaning absolutely, you may not have Lyme, you may not have Bartonella, but you could have mold in heavy metals. You could have microbiome disruption, adrenal the point being, you just go through the root causes, and it's just a simple way of making sure that nothing is being missed, because both you and I have seen the miraculous results in getting people better with this. Yeah.

With this type of protocol.

Dr. Mark Hyman
So we we kinda dove into a little bit about the protocol for treating these infections, which is just for people listening, it's not what your traditional doctor will be doing or offering you, I promise, but it probably is what you should be doing. And and the book ending chronic illness is a great resource for that. Metals, we talked about chelation. That's a little more straightforward. Fixing the gut, I've done a lot of podcasts about that.

That that's that's not that hard. I mean, it's it's it's a it's a and it requires the five r program we talked about in functional medicine, which is to rebuild your gut. The mold thing is a bit a bit of a can of worms. So I I I wanna kinda double click on the mold thing because you you keep mentioning it, and it is a persistent thing. And then there's 50% of buildings are water damaged.

In fact, I'm in my house now. Every year, have a guy come and inspect just because I got so sick from mold and almost died from it. And I paranoid about it. So every year I have it checked, anything wrong, fix immediately. But I know I I don't know you know this either, but about ten years ago, I had a series of things happen where I lived in an old barn in New England, not too far from where you have a place in Hudson Valley.

It was a 18, I think, 98 barn, so it was like a 125 years old, you know. And and and there was mold in the basement. And and I thought I didn't realize it. There was one of the windows that opened and leaked in, it kinda kinda bad. I didn't really smell it, but I started having this cough.

And I and I was, you know, running around, writing books, giving talks, trying to change the world, the usual stuff. And I was like coughing. I'm like, yeah, it's gonna go away. Yeah, it's gonna go away. And it didn't go away for a year.

And then I was like, I think it's probably my house. So like I had to check. My house checking was terrible. So I had moved out of my house, started renovating my house, and that was a whole project. And then I took an antibiotic for a dental and like a root canal that was infected, and I had the tooth pulled, but I took clindamycin.

And then I fell and broke my arm riding a horse in New Zealand. Was like boom boom boom boom. And I saw the lung doctor at Cleveland Clinic, and I got prednisone for ten days, which basically cured my cough, which was great. But then I just my whole system collapsed, and I got colitis, I got C. Diff, I end up just having this sort of cascading inflammatory problem.

And my whole gut was inflamed from basically my stomach all the way to my butt. And I developed ulcerative colitis, I was in bed, I lost 30 pounds, the mold was just devastating me. Yeah. And I even though I'd kind of cleaned up the mold, I was I was still my system was in total breakdown. And I thought I was gonna die.

I literally thought I was gonna die. I couldn't work. My months

Dr. Richard Horowitz
Mold in this is a lot more serious than people realize.

Dr. Mark Hyman
Yeah. So bad. Like and it just there was a cascading effect in my case, but I want people to understand this is a real thing.

Dr. Richard Horowitz
And and by the way, you can't just pick it up on doing a stachybotrys titer through, you know, Questroleptin.

Dr. Mark Hyman
No. No.

Dr. Richard Horowitz
So we mainly use real time labs. Neil Nathan has been one of my mentors on this with Jill Christa. Yeah. And they're mentioned, by the way, in the book. But I use real time labs where I'm doing glutathione, getting people in saunas to mobilize the toxins, and finding that up to ninety percent of my patients are showing up with aflatoxins, gliotoxins, trichotlicanes.

Dr. Mark Hyman
I mean, they're showing Mine were just so high.

Dr. Richard Horowitz
Yeah. And the problem is is that they're mitochondrial poisons, they you know, they're affecting your immune system, and they cause fatigue, brain fog, pain, neuropathy. They cause all the symptoms you see with Lyme disease. Right? So I didn't initially, I was battling with Neil going, come on, It's mostly tick borne, and then I realized over time, no.

No. It's a combination of fact. So we did real time labs, and I found a protocol, I have it under I think it's under the L is for Lifestyle chapter, with an oral protocol, because I want people to be able to use things that are generic oral that anyone can get. So we're using oral phospholidylcholine. I'm using one from orthomolecular or Zymogen's phospholine four to one.

We're using BioPC Pro. We're using a whole host and even GI detox from biobotanical research with bentonite clay and charcoal. And so I created a protocol, and the protocol's written out also like a textbook, you know, a cookbook in the book, where people understand exactly when you take these supplements with NAC, alpha lipoic acid, glutathione, phospholidylcholine, when you take your GI detox, you know, how you do this. And we do get rid of the vast majority of these moltoxins doing oral protocols. Now, some people would do IV phosphatidylcholine, Patricia Caine protocols.

My goal in doing this book was something that was accessible for the average person, just oral generic that anyone could do, and so that's why I wrote it out this way.

Dr. Mark Hyman
Yeah. I think I think I think the orals can work quite well. I found, you know, for myself, what rescued me was getting ozone therapy and hyperbaric oxygen together. It sounds like a crazy treatment, but I was desperate, and I did it. And I was better within a couple of days starting to kind of recover.

I also also did the the intravenous phosphatidylcholine protocol, which I think is one of the most effective things that personally I've ever done to resuscitate my own mitochondria and get rid of toxins. And it gets rid of not just the mole, but it gets rid of a lot of cellular toxins, and it reboots your cell membranes and your mitochondria. It's it's you can do it orally. Some people have a little trouble tolerating the high doses of phosphocholine because it's like kind of makes you have diarrhea sometimes. But it but it's it's actually important to recognize that this is a real thing, that it has medical treatment, even though your traditional doctors are not hearing about it or knowing about it.

The the testing, I want to kind of dive a little bit more on that. You talked about this real time lab, which measures urine mycotoxins. And I've heard some controversy that that might actually pick up, you know, food mycotoxins that aren't

Dr. Richard Horowitz
It's actually possible. There are food mycotides. About 25% are probably coming from foods also. Yeah.

Dr. Mark Hyman
Yes. It may not just be what's in your system, but these are low molecular weight circulating mycotoxins or toxins that come from the mold that kept getting recirculated over and over. Even if you've removed yourself from the mold environment, they stay persistent in your system, you have to get rid of them. So that's kind of what the binders and other things you're talking about. Exactly.

Yeah. What about the other lab tests do you use for for assessing this? Like the SIRS, the whole concept of chronic inflammatory response syndrome. It's almost like you're you're kind of M SIDS syndrome somewhere, but it's really deserving of mold. There's specific lab tests.

Do you find those helpful, the c four eight, g m p one, MSH, m m p nine?

Dr. Richard Horowitz
What I did what I did again, I have a specific chapter on inflammation, on how to use these biomarkers, and I did it as like a three level biomarker. Like, the first level might be do a CRP, do a SED rate, do a C four a, look at VEGF, vascular endothelial growth factor. So, like, there's a first set, I have 10 biomarkers I start with. The next level I do, for example, looking at functional medicine labs, like what's your free radical oxidative stress with lipid peroxides, eight hydroxyguanine for DNA damage, protein carbinals, TBARS. And the third level, which I think people now need to get, is get your Alzheimer's biomarkers done.

And these are these are from Quest. Yeah. Like, you can get a p tau one eighty one, p tau two seventeen, neurofilament light, and beta amyloid forty two forty ratio from Quest Laboratories, and it is completely covered.

Dr. Mark Hyman
Yeah. We do that we do that with Functional Health. We know you yes. Yeah. We have all the whole brain biomarkers on Function Health, and it's amazing.

We're seeing people using them, and then able to

Dr. Richard Horowitz
I mean, I was shocked that fifty percent of my patients were showing up with these Alzheimer's biomarkers. Right? And I just thought, oh, it's Lyme and Bart causing it. And then I as I said earlier, it's like, if you went to a neurologist with this, you're gonna be treated for Alzheimer's without finding out where the inflammation was coming from. So, yeah.

So I listed out these level biomarkers, which you've been doing actually for of course for years. But the problem is they're not all specific in certain areas. Right? I mean, VEGF we see with long COVID, but we see it with Bartonella. You'll see with cancer.

Just have

Dr. Mark Hyman
to Not know specific.

Dr. Richard Horowitz
Yeah. Not specific. You have

Dr. Mark Hyman
to know how to interpret pattern that they form. Correct. I think we're looking for patterns because any one biomarker is not gonna tell you the whole story.

Dr. Richard Horowitz
Right. Like somebody might have Lyme joint pain and their MMP nine is high. The matrix metalloprotein is high. It's like, okay, that confirms that the Lyme is affecting your joints. Right?

You always have to clinically kind of put it together.

Dr. Mark Hyman
When I first kind of got the about mold was probably close to thirty years ago. I had a patient and her daughter who came to see me, and the mother had chronic fatigue, and the daughter had juvenile rheumatoid arthritis. And they were sleeping in separate bedrooms, and I kind of took a history, and I got that there was some mold issue, and I started digging around. Turned out that I had their house checked, and they had different molds in each of the rooms who were different. And then I did the lab test, which is not available anymore.

It was it was Immunosciences, which is Aristotle Vajdani.

Dr. Richard Horowitz
I remember it. I remember it well.

Dr. Mark Hyman
And on that lab test, he you could measure mycotoxin antibodies. So not just antibodies to the mold, which you could get, but also to the antibodies to the mycotoxins. And I and I could see which molds they had in each each the mother and the daughter, and they were different.

Dr. Richard Horowitz
Mhmm.

Dr. Mark Hyman
And they matched the molds that were in their room.

Dr. Richard Horowitz
Mhmm.

Dr. Mark Hyman
And but because of this lab test, and what we found with them, there was a lawsuit where they got to recover, you know, to get their house redone for the insurance. Insurance companies did not like this. And that that

Dr. Richard Horowitz
this No. In general, the insurance companies do not like a lot of the lot of the things we do as functional Well,

Dr. Mark Hyman
mean, the insurance companies have paid for the house to be rebuilt. And so apparently, I I don't know if it's true or not, I heard a rumor that the the lab was shut down by the by the sort of authorities in California because because it was a California lab because of some of the the pressure from the insurance companies. Well,

Dr. Richard Horowitz
right now, I mean, are labs like Vibrant Laboratories and Great Plains. I mean, there are other ones that now do, you know, some of these antibodies, but you're right. That was a very comprehensive political

Dr. Mark Hyman
Yeah. And I was like, wow. That and now it's, you know, it's it's it's important to look because when you start looking, you'll find stuff. And I think that, you know, the the sad thing is insurance often doesn't cover things for these patients, and it's and sometimes the labs you're talking about are covered by traditional insurance, sometimes they're not. And I think, you know, people it's it's unfortunate.

We're you know, I don't know if you're aware of this, but you might you might even wanna apply for this. But there's a there's a grant that was established through the HHS innovation department and Medicare Center for Medicare, Medicaid Innovation for a $100,000,000 to study functional and lifestyle medicine for chronic illness. Oh, I didn't know about this. Yeah. So there's a big pot of money.

They're looking for centers to study. So if you're

Dr. Richard Horowitz
See, what I would like to do is take the 16 m's model and look at autism, ADHD, Alzheimer's disease, chronic fatigue syndrome, fibromyalgia, chronic Lyme disease, long COVID. Look at all of these diseases that are making people tired and achy with brain fog.

Dr. Mark Hyman
Yep.

Dr. Richard Horowitz
We already know they're associated to 16 points, but how much is the causality? Right? So just like I now reverse the Alzheimer's biomarker for the first time, but we need a randomized multi center trial, I'd love to see that $100,000,000 used that you take all of these major diseases affecting Americans work. It'd be a great study. Yeah.

I mean, look. Sixty percent of Americans have one chronic illness. Twenty five percent have two or more. Eighty six percent of our health care costs and seventy percent is chronic disease, and our GDP is about to go to twenty percent.

Dr. Mark Hyman
And that's why Medicare is starting to go, wait a We're we're you we're we're not getting this right. No. It's got

Dr. Richard Horowitz
to be root root cause medicine is the only way this is gonna be fixing what's going on right now. It's not what they're teaching in medical school of name the disease, throw the drugs at it. You've got to get to the underlying inflammatory factors.

Dr. Mark Hyman
It's true. My daughter just graduated medical school, and she went into orthopedic surgery because I'm not Oh, congratulations. Because, you know, regular medicine's kind of screwed. This book should really be a textbook for doctors, honestly. I mean, it really should be.

And I think, you know, for anybody who's struggling with chronic illness, who's hitting a dead end, who's gone to 30 doctors, or 20 doctors, or five doctors, or a 100 doctors, there there are answers. And I think that's what drives you and I I mean, we're probably what? You're in your sixties now?

Dr. Richard Horowitz
I'm 70. I just turned 70.

Dr. Mark Hyman
Okay. Congratulations. I'm I'm catching up soon. I'm sick gonna be 67 this year. And you know, we're still going at it because we just see the desperation out there in people, and we so we so feel the suffering.

Dr. Richard Horowitz
I mean, most rewarding thing you could do, which I think you know at this point, is getting these chronically ill patients better that have been to so many doctors. It's like, what gives you greater joy Yeah. Than getting these patients better who've been through, you know, the mill for years and years and years without answers. And I really learned this over time, the thing that gives me the greatest joy is always getting a chronically ill patient better. And and that's why I wrote this book, is I needed to get this information out for people so people would have it.

Dr. Mark Hyman
I'm working on a book now, which is is similar. It's not it's not it's not ending chronic illness, but it's it's called like how to live a hundred thousand years essentially, which is a similar idea, but it's like, here's how the body actually works. What your what your book really puts out there is this thesis, that the map we had, that the constructs we developed in medical school to diagnose people according to specialties and diseases is really outdated. And that it's helpful to a point, but it doesn't really help you navigate this chronic landscape I mean, this landscape of chronic disease. It doesn't help you navigate these patients who come in who've struggled with vague symptoms that people often dismiss, or the doctors dismiss, or the relatives dismiss as, you know, they're just in all their head, or this kind of way we kind of dismiss stuff that we don't understand.

There is there is a map, and and I and I'm so grateful that you took the time, and this is a very long book.

Dr. Richard Horowitz
Don't know. It's six it's 640 pages with over 2,000 scientific references.

Dr. Mark Hyman
But the references are not even

Dr. Richard Horowitz
The the references are no. In fact, the references are on my website, cangetbetter.com. If you wanna see the references

Dr. Mark Hyman
Yeah.

Dr. Richard Horowitz
Yeah. Go on cangetbetter.com and look on the bottom.

Dr. Mark Hyman
You'll see the reference. Problem. My book's, like, 800 pages, and I'm like and like, I've got thousands of references, and I'm happy to put them on the website. Otherwise, the book will be even a 100 page longer. I I think you and I are part of a group, a larger group of physicians who recognize that the way we think about chronic disease is just flawed.

And that there's actually an emerging framework of systems thinking, of root cause thinking, of looking at personalized healthcare, personalized medicine. No two of all have the same disease, no two all have the same causes, no two of all have the same treatments. It's very personalized. And that requires, you know, a level of of focus and understanding that, you know, most doctors just don't know how to do. And the the framework you have is really is really powerful, and it's it's essentially what I do.

I I don't actually have the same label, although a lot of this is overlapping almost entirely because it's just the body. But I think I have I have to wonder, you know, in terms of where you're going next with all this in terms of the the Alzheimer's work. Because that that paper you published, I want to sort of dive into a little bit, you know, just to help people understand. You know, you had a patient who had Alzheimer's who had elevated biomarkers of Alzheimer's, and who also had tick infections. And then you treated the tick infections, and their symptoms got better.

Dr. Richard Horowitz
Alzheimer's biomarkers got better. And it's the first time in the world it's ever been done. I didn't realize that, by the way, when I published the paper. It's in the Journal of Alzheimer's Disease Reports, April 2026, so anyone can read it. But what astonished me is this p Tau217, which most neurologists consider to be the most sensitive and specific biomarker for Alzheimer's, I reversed it completely to normal by 63% in nine weeks with an oral antibiotic regimen.

But here's the beauty is dapsone combination therapy, the number one effect it always had was improving people's memory statistically in these three seventy five patients. But what I didn't have years ago, we couldn't get these Alzheimer's biomarkers. Didn't exist. Now that I started testing people, it's like, oh my god, I possibly could reverse some of it, so that this is kind of big news.

Dr. Mark Hyman
It's big news. It's almost like measuring a blood sugar for diabetes. You can see if it goes up, you can see if it goes down, it can be reversed, it can get worse, depending on what you're doing.

Dr. Richard Horowitz
Also that Alzheimer's is not just an end stage, there are 16 factors underlying it, and I proved the amyloid p tau infection hypothesis that everyone's been talking for years, like chlamydia pneumonia can cause it, viruses can cause it, but none of the studies they'd done ever made a difference. That's what the Cochrane report was saying. So this is really the first study that gives people a glimmer of hope to say if you were diagnosed with Alzheimer's, go through the model, right, go through A is for ADHD, autism, go through the book, go through these 16 points, and work with your doctor, and then see if you do have any of these Lyme bands like we talked about for Lyme, or even Bartonella, you need to be treating this because it may do it. Now, again, we need a randomized multicenter controlled

Dr. Mark Hyman
the case study.

Dr. Richard Horowitz
This is one case study, I have a second case study, I recently did it also. In fact, I kept him in my practice longer because he had it, and he was getting divorced, I felt bad for him. Was with me for like thirty years, and I said, alright, I'll do my best, and lo and behold, the amyloid ratio, it reversed after he finished dapsone protocol. Again, it's two case studies at this point, but it means this is where the money needs to go. Right now, we should be putting our research money

Dr. Mark Hyman
Well, that's the thing, know, when you think about it, like, you know, we spent billions of dollars on the wrong thing, and even a few million in the right thing could make a massive difference. But the problem is, like you said, these drugs are off label. They're not I mean, they're not they're not necessarily making people money because they're all generic.

Dr. Richard Horowitz
Well, that's why I'm giving them to people so that they are generic and people can afford them.

Dr. Mark Hyman
But yes. But it's the drug company aren't putting millions of dollars into these research studies because the government has to do.

Dr. Richard Horowitz
Right. But the top people in our government should really be looking at this because if almost 20% of our GDP is chronic disease health care costs, we're gonna break the bank in this country if we don't do something about it apart from all the suffering from people who have these chronic illnesses.

Dr. Mark Hyman
True. And I I love that you you came at this in a similar way that I did through the Buddhist lens of, like, understanding that, you know, being in service to people and helping relieve suffering and compassion is like a it's a good way to live your life, you know?

Dr. Richard Horowitz
You know, I I like to think of myself as a good person, right, that I would have done this, but the truth is is I really do think my Tibetan teachers had a huge influence on that I wouldn't give up. Like, I kept putting myself in people's shoes going out, shit, not better. What else is it? What can I like, I just would not give up?

Dr. Mark Hyman
Stubborn like me.

Dr. Richard Horowitz
And forty two years later, it's like, all right, I've got these 13,000 people, we got better. Right? We're explaining it. Yeah. So it's I think that motivation of loving kindness, compassion, and just not giving up, always trying to get people better, you have to have this as a physician.

If you don't have this, you're just not going to go the full And

Dr. Mark Hyman
you also was forsake yourself, so you understand it. That's the thing. Not that we wish all doctors get sick so they can be better doctors, but it does help.

Dr. Richard Horowitz
And my wife, my beloved, you know, had all 16 factors made her ill, she's now eight years without one symptom.

Dr. Mark Hyman
That's amazing. That's amazing. Wow. Well, thank you for writing this book. Thank you for the decades of persistent hard work, being a medical detective, figuring all the puzzles out of the body, and helping people understand what they can do to actually get better from

Dr. Richard Horowitz
Now, you know, the beauty of this, this should give people hope that if you're someone suffering from chronic fatigue, or aches and pains, and neuropathy, brain fog, memory concentration, mood disorders, there is hope for you. It's not like you just have to take drugs for the rest of your life or live with it. I basically broke down how you do the differential, how you look at the disease, right, what are the lab tests you need to do, what are the potential, and it's what I've done over forty two years to get people better. And every story, by the way, in ending chronic illness are personal patients I have treated for with autism, with, you know, Alzheimer's, whatever it was, these are personal patients I've treated myself. True.

Dr. Mark Hyman
That's true. It's it's quite it's quite a career you've had, and people want to learn more. They can go to cangetbetter.com.

Dr. Richard Horowitz
Cangetbetter.com, and my medical detective substacks that are free to sign up. Every week, do one. I did one today on heat stress and heat strokes because of the heat wave, the heat dome. People, you know, don't realize, like, if you have cardiovascular risks and you're taking Xylitol in your diet, which has now been linked right to strokes, right, that and now you have heat stress, that you are more at risk for certain strokes than you might have been from the past, so I actually did a substack today on it. It's just because of the what's going on now in our country with heat.

But yeah. So the medical detective substack, can getbetter.com. I have a Facebook, doctor period, Richard Horowitz. You people can follow me.

Dr. Mark Hyman
And lots of Lots of books. Any chronic illness is the new one. It's great. Everybody should get a copy. It's out now, and, I'm Thank God I got my copy.

I I definitely have thought of you over the years as one of my mentors, and I it's great so to have you on the podcast.

Dr. Richard Horowitz
Mark, it's so great to see It's you been it's been too long.

Dr. Mark Hyman
Yeah. If you love that last video, you're gonna love the next one. Check it out here.