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

Mark Hyman, MD

Dr. Mark Hyman is leading a health revolution—one focused on using food as medicine to support longevity, energy, mental clarity, happiness, and so much more. Mark Hyman, MD is a practicing family physician and an internationally recognized leader, speaker, educator, and advocate in the field of Functional Medicine. He is the founder and director of The UltraWellness Center, Founder and Senior Advisor for the Cleveland Clinic Center for Functional Medicine, a sixteen-time New York Times best-selling author, and Board President for Clinical Affairs for The Institute for Functional Medicine. He is the founder and chairman of the Food Fix Campaign, dedicated to transforming our food and agriculture system through policy.

He is a co-founder and the Chief Medical Officer of Function Health. He is the host of one of the leading health podcasts, The Dr. Hyman Show with 150+ million downloads. Dr. Hyman is a regular medical contributor to several television shows and networks, including CBS This Morning, Today, Good Morning America, The View, Fox, and CNN.

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Full Transcript

Automatically generated. Please forgive any typos or errors in the following transcript. It was generated by a third party and has not been subsequently reviewed by our team.

Dr. Neil Nathan
What makes the nervous system so sensitive and once you understand that, you also know how to treat it. So when people have developed chemical sensitivity, they're often told, oh, you just have to learn to live with it. My message is, no, you don't. We can fix that. For people who developed EMF sensitivity, we can fix that.

We've been at this for twenty plus years. We have slowly filled up our toolbox in such a way that we really can help the majority of people who are who are really sick.

Dr. Mark Hyman
Alright, Neil, welcome back to the podcast. So good to have you and see you again. We've known each other for decades and decades in dealing with complex patients who are struggling often to find a way out of a whole set of symptoms that nobody can help them with that are persistent and debilitating. And you really have mapped out an incredible framework for understanding complex chronic illness, whether it's mold, Lyme, chemical sensitivities, environmental illness, chronic fatigue, the whole spectrum of things gets sort of dismissed by traditional medicine, or it gets ignored, or it doesn't have great tools for, or any of the above. You really spent your life dedicated to trying to understand why these people don't get better and what the challenges are in treating them and how to actually think about resolving these issues.

And you you know, you have been one of my mentors, one of my teachers, and I think I really appreciated your wisdom and insights and intelligence over the years. It's all particularly important for me because I personally have had chronic fatigue syndrome. I personally have had Lyme disease and Babesia. I personally have had severe mold illness and almost died. I have really had these problems, heavy metal toxicity, mercury toxicity, and I've had to figure that out for myself.

And now I feel healthy and good. I just went for a, you know, 15 mile bike ride this morning, almost 67. I feel great. My time's about the same as it was, you know, ten, fifteen years ago on the loop. So I think, you know, the the reason I share the story is because I I think there's hope out there, and you you provide a lot of hope.

So Neil, why don't we start out by you kind of framing the issue. Like, why are so many people struggling with all these unexplained symptoms, and why are they so sick without any kind of clear diagnosis? And often they're told their labs are normal, know, that this is just psychological, and why is medicine sort of missing the boat on this?

Dr. Neil Nathan
The way conventional medicine works is based on a concept that is great for simple issues and absolutely doesn't work for chronic illness of almost any kind. It's based on the concept that, okay, I come into my doctor and I've got a sore throat, he does a strep culture. It's positive, he gives me penicillin and I get better. Right. Nice.

Simple. But chronic illness doesn't work that way. In the body, everything is connected to everything else. And conventional medicine is based on a one cause, one diagnosis, one treatment model that simply does not fit anymore. The world we live in is is absolutely complicated.

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

Dr. Mark Hyman
Yeah. And

Dr. Neil Nathan
we have helped thousands of people

Dr. Mark Hyman
Yeah.

Dr. Neil Nathan
Recover their health by knowing that there is another model, there is another way. But another part to your question is, we live in an increasingly toxic world.

Dr. Mark Hyman
Yeah.

Dr. Neil Nathan
It is now known that there are 350,000 new chemicals in our environment in the last seventy years. The vast majority have never been studied in terms of whether they affect our health or not. And we add to that, the increasing exposure to electromagnetic frequencies, EMFs. And so, people are rolling out 10 gs now with no concept that we're being exposed to massive amounts of an energy that our bodies were never designed to deal with. So we have an increasing amount of toxicity.

Our livers have to deal with things that hundred years ago, no one had to deal with. And they're overworked. And so slowly, the toxins continue to accumulate in our bodies. They trigger inflammatory reactions which become chronic and we are off to the races in the wrong direction. I think that's what's happening and it's really tragic.

Dr. Mark Hyman
It is tragic and I and I you know, don't know if you ever experienced any of these problems yourself, Neil, but I I suffered it from the inside out. And I almost died from mold, my whole immune system collapsed, I got tremendous amounts of inflammation, I went in a terrible catabolic state. You know, with Lyme disease, had severe fatigue, brain fog, cognitive issues. And you know, developed those weird sensitivities to foods, weird sensitivities to chemicals. I would get rashes when I would eat certain things.

Like it was just really strange how my body completely broke down. And I think you know, I felt so disabled by it and traditional medicine offered no solutions. And that's really how I got into functional medicine thirty years ago. And I think that a lot of people out there listening have these issues, whether it's chemical sensitivities or histamine responses. We call them MCAS now, basically an advanced form of histamine intolerance.

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

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

Dr. Mark Hyman
Thank you,

Dr. Neil Nathan
by the way. And you're welcome, by the way. The trick is to identify all of the root causes, not just get focused on one, but also to try to prioritize which root cause needs to be treated in watch order. And sometimes that varies from patient to patient. It's not as simple as it sounds.

The biggest root causes that we see are mold toxicity, Lyme disease. We can talk about other environmental toxicities as well, and long haul COVID. Those three are the biggies of what we have to sift through. And a lot of physicians or patients get hung up on things that are downstream from that. The mast cell activation, limbic dysfunction, vagal dysfunction, methylation dysfunction, mitochondrial dysfunction, recurrent Epstein Barr or other viruses.

And they could get really caught up in that for years, thinking I'm treating a root cause, but it's really not the root cause. The root cause is something more profound that is weakening that immune system. And that's what we have to really get started on because otherwise, we're just gonna be not making any progress.

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

Lyme, Babesia, Borrelia, Bartonella.

Dr. Neil Nathan
I mean Lyme and its co infection buddies.

Dr. Mark Hyman
Yes, I knew you meant that. Just wanted to clarify for

Dr. Neil Nathan
a minute. Okay, yeah, yeah.

Dr. Mark Hyman
Because the doctor just got a flu with this as we are. But I think this is actually such an important point. And you highlight in your book and you talk about this, the importance of doing things in the right order. That you can make someone sicker by doing the right thing in the wrong order. I wrote an article like probably twenty years ago called The Right Order of Things, which is exactly this.

Start with the basics, then you kind of layer in. If you start doing some things that might be helpful to someone later on, early on, it can make them worse. So can you kind of explain that whole phenomena and why we have to sort of be sort of structured in how you approach these problems and not get people sicker?

Dr. Neil Nathan
By the time people reach me, many of them were like you at your worst. And which they're really exhausted, can't think straight, anxious, reacting to everything. And in that state, it's especially important to do things in the right order. Because if you do it in the wrong order, they're gonna get worse. And that order has to be figured out.

For most people, starting with mold toxicity is the right order. For one major reasons for it, and I'll give you several. One is, mold toxicity looks like Lyme disease with its co infections. Looks like long haul COVID. And that's why teasing it out by symptoms is impossible.

So if we know someone has mold toxicity, which has shown up on a very clearly on a urine mycotoxin test. The other are a little bit harder to diagnose by test. The easiest one to test for is mold. And if you have a mold positive test, that's a great place to start. We know it with certainty.

A lot of the time, if we get rid of the mold, the people get either completely well, which means we don't have to go down the line rabbit hole, or they get 70% better and what's left symptomatically helps us hone in on what's the next layer that we have to be treating. So typically, I will start with mold. But having said that, it is more complicated than that. Because for most of my patients, mold toxicity will trigger limbic, vagal and mast cell dysfunction. And those all represent, from the body's perspective, safety or lack of safety.

And we know that if a body doesn't feel safe, it can't heal. Not psychologically, physiologically.

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

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

If we approach it that way, we will make progress. But I've had countless patients spend years working on Epstein Barr or mitochondrial dysfunction, methylation dysfunction and getting nowhere. Yeah. Because those are downstream. Not only is it downstream, in a state of cell danger response, which for your listening audience.

Cell danger response is a concept developed by Bob Navio. It's a brilliant way to understand the complexity biochemically of what's happening in almost every chronic condition. And on a simplistic level, on a cellular level, which extends to the whole organism, if someone is experiencing infection, toxins, or stress, or combinations of those, the cell shuts down in order to contain the infection, to deal with the stress, which extends to the whole body. And until that gets addressed, you're not going anywhere. And that is not psychological.

You can't just decide, oh, I'm gonna be better. You have to literally get the body better so it experiences that I am safer. The threat is either gone or almost gone. Now, I can proceed to healing. So that helps us to understand again, what to do in what order.

Because you're in the first phase of cell danger response, the body will not respond to methylation or mitochondrial treatments. It won't respond to plasma exchange. It won't respond to peptides. It won't respond to much of that. It's basically going, hey, I'm on survival mode.

I That's a lovely thing you're doing for me. I can't deal with it until I'm safer. So that's how I conceptualize the order in which we we treat.

Dr. Mark Hyman
Yeah. It's tough. I almost died from mold. I'm I'm in this barn where you can see the background. It's an old 125 year old barn.

Was super moldy. I was coughing for a year. I was working really hard. I was doing Cleveland Clinic, and I was just kind of ignoring my symptoms. I kind of knew something was up.

House kind of smelled a little moldy. Was like, maybe something's going on. I checked it out and sure enough it was full of mold. I moved out, but I ended up getting this cascade of things that happened where I had a root canal removed, had an antibiotic, gave me C diff and my whole system collapsed. I went into this massive inflammatory cell danger, catastrophic, catabolic state where I was in bed for five months.

And I lost 30 pounds and I couldn't eat and my whole colon and gut were all inflamed. And it was tough to get out of that. And I think you know, for some people, you know, the question is what the what are the right levers and where do you start? And for me, was doing all the dietary stuff. I did all the supplements I think I could do.

I thought I was doing all the right things, but it turned out I I had to, and it sounds kind of like a crazy option for people, but I heard one of my patients, and I usually listen to my patients because they usually they report what works out there in the wild. He said, I did ozone, I had really bad mold poisoning and I did ozone and it helped me. I'm like, okay, well maybe I'll try that because I'm dying. I don't know what else to do. And I did it and it was like literally in two days it snapped me out of it.

I don't know how it exactly worked, but then I sort of continued on to a mold detox. I think the phospholipid exchange I find really helpful too, is a whole different approach that was developed by Patricia Kane and others that uses high doses of phosphocholine intravenously along with glutathione and methylating nutrients and other minerals to help mobilize the toxins. I found that extremely helpful. I find it helpful for a lot of patients. So those, there's a lot of things that are in the toolkit for people but you kind of, you know, I think what you're talking about Neil is that you really have to have the right map for people really think properly about this.

We can kind of

Dr. Neil Nathan
back up a little bit and talk about this phenomenon of toxicity versus sensitivity. What's the difference? And how does this shift happen from like being tolerant of things to being intolerant? Like people get intolerant to food, the smell, the light, the sound, and react to everything. So how does this work?

Sensitivity refers to something neurological. Like our senses, all of our senses. Touch, smell, hearing, light, sound. So sensitivity refers to sensitivity to light, sound, touch, smell. Toxicity is there's a toxin in our body, which is inflaming our body on a systemic level.

So it's helpful to separate that out. And we can do that just by talking with our patients in history. One of the things I ask every patient is, have you developed any sensitivities? And we ask one specifically. If they have, they're already telling me that their limbic and vagal systems need help.

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

Sensitivity is those senses are on high alert. And people become exquisitely sensitive to smell for example, where they can smell mold for example, and nobody else in the family can.

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

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

Dr. Mark Hyman
Thank you.

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

Dr. Mark Hyman
It's it's it's amazing the body's recovery capacity. And and if you know, for people listening, it feels hopeless and I know people struggle with these conditions, never feel like they get the answers, but there is a framework for thinking about this. And your book is such an important contribution in the field. It's called Toxic Kill Your Body from Mold, Toxicity, Lyme Disease, Multiple Chemical Sensitivities, and Chronic Environmental Illness. And you wrote it and then you redid it and updated it in the second edition, includes the MF sensitivity, environmental toxins, COVID, long COVID.

I I think this is is really important. I I personally use the book because I think it's it's such a detailed resource for understanding these chronic illnesses and for giving hope to people who really struggle.

Dr. Neil Nathan
So I would I would add to that. I wrote a book called, The Sensitive Patient's Healing Guide, which focuses on the sensitivity component. And I have 20 experts who contributed to that book, where we go over what makes the nervous system so sensitive. And once you understand that, you also know how to trade it. So when people have developed chemical sensitivity, they're often told, oh you just have to learn to live with it.

My message is, no you don't. We can fix that for people who developed EMF sensitivity. We can fix that. So these are things that now that we understand how the body physiologically becomes more sensitive, we also have the capacity to fix it. I wanna really emphasize the hope that you're referring to, which is we've been at this for twenty plus years and we have slowly filled up our toolbox in such a way that we really can help the majority of people who are who are really sick.

Dr. Mark Hyman
So let's talk about you know, how we diagnose these things and how we treat them and what works and what doesn't work. And I think it'll be helpful to kind of get your perspective because this cocktail of chronic persistent illnesses would say as a doctor, if I could do two things, it would be to get rid of mold and lyme related illness from the planet because they cause so much suffering. But we have to deal with it. And the question is, traditional medicine doesn't really sort of acknowledge these conditions. The diagnostics are really not used.

What are the diagnostics that you use to help figure this out? And then let's talk about after that some of the right ways of approaching this from a treatment perspective.

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

Dr. Mark Hyman
So you think Yeah. Because people dismiss it and say, oh, this is just toxins from food, it's not really real when you

Dr. Neil Nathan
It is not. Does it contribute a teeny bit to maybe having it in your urine? Yes. But not to an extent that we wouldn't pick it up on our testing. Urine mycotoxin to me is the standard.

Anyone who presents with a complex illness should get a urine mycotoxin test. If you want me to talk about brands or which ones are better than others, I'm happy to do that, but I can otherwise leave it alone. Bottom line is you need a good test to measure.

Dr. Mark Hyman
So you're saying urine urine mycotoxins, and and then there's also a whole field of of you know, Richie Shoemaker who's one of the pioneers in mold related illness has a phenomenon he talks about called SIRS. There's a lot of biomarkers that are used including, you know, MSH or C4A or TGF beta-one. These are like blood tests that you can get. Are they useful? Are they helpful?

Do they not matter?

Dr. Neil Nathan
So number one, if you're interested, I've just finished a podcast with Richie in which we discussed the differences in our approach in about a two and a half hour podcast that we did with Scott Forsgren and his Better Health Guy podcast. So if you want a excruciating discussion of the differences, that's gonna be available and I'm really happy that we've been able to do that. All those tests that you're measuring, their blood tests, TGF beta one, c four a, MMP nine, VEGF, they're indirect measures of inflammation. They're helpful in telling us, yes, you're inflamed, but they will also be positive not just for mold, but they'll be positive in Lyme and co infections, other infections, some viral infections. So if you wanna document that someone is inflamed, they're helpful.

Will they pinpoint mold? They won't. The urine mycotoxin test is absolutely specific for mold. And forgive me, it's not rocket science. If you're peeing out mycotoxins, they're coming from your body.

You've gotten them into your system. So if we are We can measure significant amounts of mycotoxins, mold toxins in your urine, you have it. There's no Forgive me, there's no really question about that. To me, that is the single most useful test to help put this away. It's very accurate and very useful.

Then in the Lyme field, our testing has improved. We've gone from the fairly inaccurate serologies and western blot to much more accurate immunoblots that measure many more species of Lyme and Bartonella than we used to appreciate before. And there's some newer testing which I'm really fond of. Bob Mosiani has a t labs test, where you can send a specimen of your blood and you can look at it under the microscope with a special fluorescent stain that only stains that particular microbe. And it will tell you, is this in your body right now?

And I fight that that a particularly useful test. Because our serology tests are testing in our immune system.

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

Dr. Neil Nathan
It's for The immunological tests are great for helping us to know you have it, or mostly that you've been exposed to it. But even when you're cured of it, your body's gonna still make those antibodies because of what we call immune memory. The same concept that we use to For all of vaccinations is immune memory. So what I always wanna know is, okay, I've made the diagnosis. How am I coming with treatment?

Have I gotten enough of the bugs out of the system so that this We don't have to keep treating and I don't have to keep using antibiotics. And for me, the TLAB test is very helpful with that. I'll give you one other test that I'm currently very fond of, which is Bruce Patterson's Radiance Lab does a test for 14 different cytokines. Cytokines are the result what our immune system triggers in our body when we're fighting these threats of toxins and infection. And it turns out, especially from doctor Patterson's research, that there's a different pattern of cytokines in Lyme.

There's a different pattern of cytokines and long haul COVID so that we can identify that much better. And I'm doing research with him right now in which we're identifying a different pattern yet from old toxicity. So with a single blood draw, what you can look at is, what is this immune system fighting right now? What cytokines is it generating in a pattern that would immediately make me think, oh, this is a long haul COVID pattern. And it could be all of them together because we see that really quite commonly.

So we are now evolving much better tests than we had twenty years ago to begin to hone in on which of these is the biggest issue here and what do I need to treat first? So the tests we can

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

Dr. Neil Nathan
My bias is to start with the primary cause. I have had a lot of my colleagues start with improving detoxification strategies, getting the diet built up. But the problem is, the vast majority of patients who have mold toxicity have SIBO. They have intestinal dysbiosis. And you can't fix that until you get the mold and candida out first.

And one of the major tenets of functional medicine is fix the gut first, everything will follow. The exception to that is mold, which is if you have mold and candida almost always comes with mold, and you're not working on it, every strategy you use is likely to not work well. You can Our patients will respond to refacts and then they'll get better for a couple of weeks and then they'll go right back to where they were. So my approach is to get going on the causation first. And honestly, once you get that out of the system, the body's innate healing powers will fix most of anything else later.

And if it doesn't, then we can use our normal tests and go, okay, you're deficient in zinc and selenium, I can give you these and those will be helpful to you. I can look at your fatty acid imbalances and we can balance that out. But you'll respond infinitely better if you get rid of the primary driving root cause first.

Dr. Mark Hyman
So let's talk about that. We talked about sort of diagnostics and it seems like mold and ticks definitely are things that I think about with every patient who's got anything that's chronic. Even if it's autoimmune disease. I mean, doesn't have to be chronic fatigue, or histamine intolerance, or any of these other things. It can be an actual disease that it underlies.

For example, I had ulcerative colitis, that's what I got. But that wasn't really the problem, the problem was the mole. And as soon as I got rid of the mole

Dr. Neil Nathan
You may not know this, but me too. I also got ulcerative colitis from my mold. I Wow. Okay. Brothers from another mother.

What can I tell you?

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

And including mold, also we all wanna talk about the tick stuff a little bit. Sure.

Dr. Neil Nathan
First, I think this is central, we start with a good history. Again, when we were talking about why conventional medicine often doesn't get anywhere, it's my histories are two hours long. So you really have to really listen to the patient. They will usually tell you what's going on if you just sit back and listen and don't interrupt their story. If you don't chime in or or push it.

But then once you hear their story, then you can really dig into some of the details. Asking them about as in your case, do you have any mold exposure? Do you smell any mold? Do you have a barn or something nearby that might have moldy hay in it? Just saying, water damage building, water You start asking these questions.

As I said, I ask every patient about their sensitivities. As soon as they start saying, yes, I'm sensitive to light and sound and smells and chemicals, I already know they've got a limbic issue and we're gonna need to address that early on. If we don't, we're not going anywhere. I'll ask about mast cell activation early on. I'll ask them about, do you ever get a reaction to anything you eat or drink immediately?

There are other manifestations of mast cell activation, but that's a tip-off. When someone says, I get immediate bloating and gas while I'm eating it, I don't even have to finish it. Great. I already know you have mast cell activation that that's a piece of it. And then I look for the vagal piece as well.

I'm looking for autonomic nervous system symptoms, palpitations, temperature dysfunctions, the vagus controls the gastrointestinal tract. So I'm looking for any GI symptom probably has a vagal piece to it. POTS, low blood pressure are all things that will tip us off to there's a vagal piece to it. So I'm trying to as I listen, put together in my mind, what was the root cause? What has it triggered?

What are the downstream pieces? So I can then formulate my bigger picture. So yes, I always wanna treat root cause. But for many of our patients, I can't treat root cause until I deal with the limbic vagal mast cell systems first.

Dr. Mark Hyman
And how do you deal with those things first?

Dr. Neil Nathan
Well, for all of those Each of those has their own treatment. So for the limbic system, there's a number of very excellent programs out there that patients can do to do the reboot. There's Annie Hopper's Dynamic Neural Retraining Program. There's Ashok Gupta's Amygdala Retraining Program. Amygdala is another word for limbic.

There's Kathleen King's Primal Trust, those are three of my favorites. And there are some others. On the vagal side, there's a bunch of new devices on the market called vagal nerve stimulators. Gotta be careful with them. My sensitive patients can't take the most direct stimulation.

There are devices like gamma core, which go greatly over your neck. There are devices that attach to the earlobe, which is a branch of the vagus. Most of my patients need to use indirect stimulation. So I use Apollo Neuro a lot to help reboot the vagus. I love osteopathic cranial work for the vagus.

I love frequency specific microcurrent. And then there's virtually anything that quiets the sympathetics, Tai Chi, yoga, meditation, they're all excellent. But it usually takes several vagal strategies coupled with limbic to move people off from the super sensitive bedridden into more functional and then able to do more. Then we get for mold into taking binders that are specific for what we see in their urine. So we know that whatever mycotoxins show up in your urine, we have a table in my book, Toxic.

There's a big table that shows what we know from the medical literature of which binders work specifically on which toxins. You can literally look at your report and figure out, okay. Wow. I'm gonna need charcoal, clay, chlorella, and well coal or cholestyramine to get this out of me.

Dr. Mark Hyman
So there's specific binders for specific mold toxins, is what you're saying?

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

So that's the mole treatment.

Dr. Mark Hyman
Those binders and antifungals, did you also add in things like ozone or phospholipid exchange or other therapies?

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

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

Dr. Mark Hyman
And what about what about the tick stuff? Because the molds, binders, antifungals, there's those phospholipids, there's a lot of great therapies. Tick infections seem harder and more treatment resistant.

Dr. Neil Nathan
They are harder and they're harder on the body because in my experience, most people won't get well with herbs alone. Most people, they're helpful and I use herbal approaches. But for most people, they'll need an antibiotic approach for a longer period of time than anybody wants in order to really get them free of that particular microbe. Unfortunately, the same antibiotics don't work the same for the different co infections. So we'll use certain antibiotics for Lyme itself, others for Bartonella, others for Babesia.

And then there's the lesser known ones of anaplasma and Ehrlichia, etcetera. I But mean, it's a whole field as you well know. There's a whole group of physicians that are called LLMDs, which is Lyme literate MDs in which we've all had to study this because it's not as simple as that strep infection thing I talked about where you have a strep throat and you take an antibiotic for a week and you cure it. Doesn't work that way with these bugs, they're way more complicated. So the whole Lyme field, think is more complicated.

But again, it takes a whole armamentarium of things that work on these particular critters to get them out of the body. They're what They are called stealth infections. They hide inside our our cells. They're not just floating around in our bloodstream there. We have to literally pull them out of the cellular location and get at them, which is, forgive me, complicated.

Dr. Mark Hyman
Yeah, it is, it is. And I think you know, I think you know, we're talking about how we can get people better. And you're dealing with the patients that are at the end of the road. And I have most of my career as well, my joke was I worked at a health resort and I'm a resort doctor, but the doctor of last resort. I think you are too.

Are there people with these complex chronic illnesses that you just haven't been able to help? Like are there people who just are so stuck in their biology they can't kinda correct it? Because what happens I see in the biology is it's sort of stuck in this feed forward cycle and I was caught in that and I couldn't get out of it. It was like a was a loop. No matter what I did, I couldn't break it.

Dr. Neil Nathan
I do. I don't think there's a physician alive who can say they cure every person they ever see and I'm certainly not one of them. I would say I've helped the vast majority of people I work with, but I certainly have folks that I haven't helped. And then I'll give you some reasons for that. In the mold field, the single number one reason that people aren't getting better is they haven't been able to get out of a moldy environment.

They haven't been able to remediate their home properly, still in it. They financially can't afford to leave. And if you can't get out of the mold, you can't heal. So that's the biggie. For other people, I think that are really sick, there's often a spiritual, emotional, psychological or energetic block in which there's something else going on preventing them from responding to the treatment we're giving them on a deeper level.

And that requires an even more in-depth work with the patient of figuring out with them. I'll usually say to them, you're not responding to what I'm doing. Do you have any ideas about where your block is or where you're stuck? And most people have an idea. Most people will say, well, know, I had all of this early childhood trauma and I never I worked through some of it, I'm not sure I worked it out.

And what I find is, if we then do get into that, that might take another year before they even able to get back to treatment, then they can proceed. But we have to find the block. I call it the block where there's energetically, there's something blocking energy flow in the body. There are some energy healers sometimes who can do some great work in that regard getting things. We just have to look deeper.

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

Dr. Mark Hyman
Yeah. Think that's really important, Neil. I mean, people get discouraged, disappointed, and frustrated, and sometimes suicidal. And I I definitely found myself there at different moments in different illnesses that I had and I was like, I can't do this anymore. But I think hopefully people take away from this conversation that there is a way to think about this, that there is a roadmap, that there is an understanding of what's happening when people have these chronic complex illnesses.

And that if you're struggling, don't be hopeless. There is a way through it. I think I would encourage everybody to get your book and follow you on your social media, on Instagram and your website neilnathanmd.com and the book is called Toxic, Heal Your Body from Mole Toxicity, Lyme Disease, Multiple Chemical Sensitivities and Environmental Illness is out now. And Neil, thank you for your dedication, your work, your teaching of me, your helping of me when I was sick. And I think you and I are both proof that there is a way out of this.

We've both been very sick with this and probably motivated a lot of our work. And then there is a way to think through how to solve these chronic complex illnesses. So thank you so much for your career and work and dedication and all the things you put in your book.

Dr. Neil Nathan
Thanks. My take home message is everything we talked about today is tradable. Yeah. So, yep, there's hope.

Dr. Mark Hyman
Absolutely. And I'm a living example. I've had all of it. I've had mold, I've had mercury, I've had Lyme, amnesia.

Dr. Neil Nathan
Everything. You're right. And still and still here to laugh about it.

Dr. Mark Hyman
I'm still here. I'm feeling great, actually. Actually, I feel better than

Dr. Neil Nathan
I So felt That's that's wonderful. Fabulous.

Dr. Mark Hyman
Yeah. Alright, Neil. Well, take care of yourself, and we'll talk soon. If you love that last video, you're gonna love the next one. Check it out here.