The Link Between Autoimmune Disease, Chronic Fatigue, And Hidden Infections

Mark Hyman, MD

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Dana Parish: And I think a lot of people suffer from anxiety and depression, along with their "autoimmune diseases" and people tell them, "Well, you're anxious because you have fibromyalgia or because you have RA." No, you're not anxious because you have those things necessarily. I mean, yes, they suck, it's depressing, but there's a brain component here. There's a neurologic component. Dr. Mark Hyman: Welcome to The Doctor's Farmacy. I'm Dr. Mark Hyman. And that's Farmacy with an F, F-A-R-M-A-C-Y, a place for conversations that matter. If you've ever been chronically sick and struggled to find the answers, you should listen up because this conversation is going to matter to you, because it's about something that's pretty prevalent and mostly ignored or overlooked by traditional medicine, which are chronic infections and autoimmune disease. We're going to get deep into this with our guests today, which is Dr. Steven Phillips and Dana Parish. Dr. Phillips is a well known physician. He's a renowned Yale trained doctor, international lecture and immediate go-to expert. He's published many papers in medical literature, and cured over 20,000 patients with complex chronic illnesses in nearly 20 countries. He's experienced firsthand the nightmare of an undiagnosed serious infection, nearly dying from his own mystery illness and having to save his own life when 25 doctors could not. And that sounds exactly like me, Steven. So, I've been there. I get it. Dr. Mark Hyman: And Dana, thank you joining us today. Dana Parish is someone who's recovered from a Lyme disease induced heart failure, which is not actually uncommon and was improperly diagnosed by some of the top doctors in the country, and Dr. Phillips saved her life. She's a chart topping Sony ATV singer songwriter, who's written songs for people like Celine Dion and others. She has become a major voice in the world of chronic illness and her popular column on Huffington Post has been read by more than one million people globally. Welcome Stephen and Dana. Dana Parish: Thank you. Dr. Steven Phillips: Thank you. Dana Parish: It's great to see you. Dr. Steven Phillips: Great to be here. Dr. Mark Hyman: Okay, let's get into it. So we are living in a planet that's very polluted, the air is polluted, there's toxins everywhere, we're eating processed food and refined foods. We're taking all kinds of medications and antibiotics that affect the microbiome [inaudible 00:02:07] C-sections. And all these have screwed up our immune systems. And we're seeing part of the immune dysfunction in COVID, but it's much deeper than that, it existed way before COVID, which is these chronic low level diseases that make people just not be able to live their full lives. And I know I felt that clearly both of you have been through that. And what we're seeing is this increasing autoimmune pandemic. There's 80 million people who have some type of autoimmune disease. Dr. Mark Hyman: That's almost two or three times as much people who have diabetes or heart disease, which is kind of staggering, but they're all different ones like MS or rheumatoid arthritis or Hashimoto's. So you have different specialties talking about them. When you look at autoimmune disease as a whole, it's a big deal. And the question is, why are we seeing such a rampant increase in autoimmune disease? Is it toxin? Is it food? Is it infections? It's something else. And you both have written a book together called Chronic, which starts with the premise that a lot of autoimmune diseases are exploding often because of underlying chronic infections. So Dr. Phillips, tell us how you figured this out. How did you come up with this hypothesis and what made you interested in this idea of chronic infections and autoimmune disease? Because even though we know in medical school we learned a few autoimmune disease may relate to infections. It wasn't really a predominant theme. Dr. Steven Phillips: Right. So thank you. So I've been in practice since '96 and I started treating lots of Lyme patients. And at that point, Lyme was the infection that got all the intention. And for a lot of us, it's the one that any of us has heard about. We haven't heard about these many other chronic infections, but people come in with diagnoses of, is it Lyme, is it Ms? Is it Lyme, is it fibromyalgia? Is it Lyme, is it inflammatory arthritis? And I would treat them for the underlying infections that I found and what was diagnosed as a possible autoimmune illness just evaporated. I would see it time and time again, and it wasn't all Lyme. I was looking for other chronic infections and finding them. Dr. Steven Phillips: And then I came upon the realization about the fact that there's this is precipitous rise in chronic and autoimmune illness around the world has been this slowly exploding pandemic, rather than, as opposed to COVID, which has just taken the world by storm. This is kind of just crept up on us. So, last 30 years, and it's shockingly common. And because it is siloed, because it's between different medical specialties, no one's really putting the pieces together about why is this happening? Because the infections have been here forever. And like you mentioned, we're living in an increasingly toxic environment. I think that a lot of us are less able to deal with infections that are common in the population. Dr. Mark Hyman: So, what happened to you? Tell us about your journey with chronic infections and autoimmune disease. What happened to you? Dr. Steven Phillips: So, a lot. Yeah, I went through the mill. So, I first got Lyme, just regular garden variety Lyme, like so many people do who live in Connecticut, and it was a moderate case. It wasn't traumatic. It didn't disable me, but I realized by going to many infectious disease doctors, and ultimately ending up in the office of doctors like myself, Lyme doctors, that there's real discordance among the medical community on how they approach chronic illness, and they didn't... No one seemed to know what was going on. I gradually got better and I had many relapses in it. It wasn't a three course of doxycycline that got me better. And then I was really fine. I still had occasional relapses, but I was a healthy guy. I could run five miles. I could play tennis all day and work six days a week, which I did for many, many years. Dr. Steven Phillips: Then in 2010 while I was sleeping, I got spider bites and I didn't think anything of it. And with those spider bites, a couple months later, my body exploded with arthritis all over. Rapidly progressive to literally every joint in my body, especially my spine. And I went to 25 doctors they couldn't help me. I went to other doctors like myself who thought it was maybe prior Lyme, but I was the only one that's saying that it wasn't. And none of the antibiotics that had helped me previously helped me for this case. And I went to a rheumatologist who diagnosed me with rheumatoid arthritis and spondylitis, which is arthritis to the spine. And it progressed very rapidly within six months, despite treatment with different medications, including many antibiotics, I couldn't walk. And I ended up not walking for almost two years. I had to give up my practice for two and a half years. Dr. Steven Phillips: I was completely bedbound for about a year and a half, and I almost died on many occasions. I lost 50 pounds. I couldn't turn over in bed. I couldn't sit up on my own. I needed 24-hour home care. I got severely anemic. And I had fevers 102 every night. It was a dire situation. And I figured out in the last minute and put it all together and I saved my own life. And it's not just saved my life, went back to a full life. And I back in practice since 2013. I lecture all over the place before COVID traveling around the world and not limited in any way. And when I went back to my three top rheumatologists, when I recovered and I told them this is how I got better. Will it change how you practice? They're like, "No, I'm glad you got better, but we're not going to change." Dr. Mark Hyman: Tell us more. What actually got you better, what you did to recover, and what was the root cause? Because functional medicine is really about looking at the root causes of disease and this is really what you're doing. You're looking at not just the label that people get like rheumatoid arthritis, but what's underneath it, and how do we fix that. Dr. Steven Phillips: I went to regular doctors and I went to functional medicine doctors as well. Like I said, I went to every specialist I can find. And I did the elimination diet. So, they didn't find any heavy metals or anything like this. She wasn't able to help me to be perfectly honest. And I took lots of antibiotics to flare me up, but didn't get me better. And really it came down to that my infection was Bartonella, which is a antibiotic refractory infection and it needed really just specific antibiotics. And that's what got me better. Dr. Steven Phillips: I took lots and lots of herbs that didn't help. And at first I wasn't a believer that herbals were helpful. And then I took my first herb to rock my world and it caused this huge Herxheimer massive improvement and that was liposomal artemisinin. And then I was like, "Oh, so that's how herbs are supposed to work." And then I ended up getting tremendous benefit from liposomal oil of oregano, my second herbal, and then monolaurin. So, there were a few supplements or herbals that were found really, really beneficial. But primarily for me, it was antibiotics. It was things like doxycycline and rifampin and Bactrim. Dr. Mark Hyman: Yes, so those antibiotics are strong antibiotics, but Bartonella is really one of those tough infections. It's one of those tough infections that's often hard to find and hard to treat. And so, people suffer for years from leading things like this, and I've seen people literally for decades have problems, and then you treat them and they get better. It's pretty miraculous. Dr. Steven Phillips: I went back to rheumatologists and they looked like I was a Martian. I mean, one was delighted that I got better. One treated me like, it can't be, in disbelief. And I did a little dance in front of him to try to convince him. I mean, because he saw me not walking and I was like, "Look, I'm dancing. I'm not a good dancer." And then one was just looking at me like I was a one-off. Like I'm a one in a million case. And she was like, "Look, one in a million things happen." I'm like, "I'm not one in a million." I mean, always, my mom had told me I'm special when I'm a kid, but I don't think I'm one in a million. And I think there are other people that have very similar things. Dr. Mark Hyman: Yeah, that's funny. I remember giving a talk at Harvard and I was presenting about a case of autism that had dramatically turned around and one of the pediatricians there was like, "Well, this might just be a case of spontaneous remission." And then one of the other doctors, "Well, Dr. Hyman's had five cases of spontaneous remission in his practices this year so far." If you understand what the roots are." And you also talk about in the book, your dad who had pretty bad heart failure and needed a heart transplant. Dr. Steven Phillips: No, he did not have a heart transplant [crosstalk 00:09:59]. Dr. Mark Hyman: He was going to need one, right? Dr. Steven Phillips: Right. Dr. Mark Hyman: So, what was the discovery there? Tell us about your dad- Dr. Steven Phillips: That's what galvanized my interest in doing what I do. It wasn't my own case. Like I said, my case of Lyme was pretty moderate and I wasn't planning on doing this as a career. But when I started learning about this, my heart, my father had a case of what they thought was a viral meningitis in 1975. And then shortly after that became a non-specific heart palpitations and it got just worse and worse than it turns atrial fibrillation, a specific type of arrhythmia. And then it went into heart failure, and we took him to all the best doctors in New York City at all the top teaching hospitals. And we don't skimp, we went to the best, and they all couldn't save him. He got worse and worse. The injection fraction between 10 and 20, they said that his lifespan would be measured in months without a heart transplant. Dr. Steven Phillips: I was just finishing up my residency at Yale. I was doing Lyme research. I'd already had some experience with Lyme personally. I looked it up and I was like, "Holy crap, Lyme can do this." So, I went to the cardiologist and I said, "You know, Lyme can do this condition, dilated cardiomyopathy. Can we evaluate him?" And he rolled his eyes and discounted the whole thing. They published a study in 2015 where they looked at people with his type of condition. His type of heart failure. Went in and did heart muscle biopsies on all of them and found that 20% had Lyme DNA. He made a point in the study to say that almost two thirds of them had negative Lyme tests. So if you don't really have a big suspicion about what these infections can do, you're going to miss it, and I've treated about 50 cases- Dr. Mark Hyman: See, what you just said it very important. I want to emphasize it. You say that 20% of the biopsies in the heart muscle were positive, but two thirds of the people who had the positive test had a negative blood test. So in other words, you can get a blood test [crosstalk 00:11:50] fine. Your doctor says your labs are fine. You don't have Lyme, but actually if you look deeper, you can actually find it because it may not always show up in the regular lab test. It's an important point. Dr. Steven Phillips: Yeah. You have to ask yourself who goes and gets a heart biopsy to diagnose Lyme? It's the silliest thing. The tests are antiquated. They're 40 years old. I always say I won't get on a 40 year old airplane. I'm not going to trust my health to an outdated technology with blood testing. But long story short, he wouldn't evaluate them because my dad never had arthritis and [inaudible 00:12:21] palsy. He said, "You're a doctor. Now do it." I was just a fresh out of school, basically. And I basically treated him and his heart function completely normalized. He is 88 years old now. He never needed a heart transplant. He's not in heart failure at all, and that's the story. Dr. Mark Hyman: That's incredible. So, what you're saying is essentially, you cured an incurable condition according to traditional medicine with treatment of his Lyme disease, which was causing his heart failure. I think this is important to underscore because so much of what we see in my world, in your world, are people who suffering from chronic illnesses who just don't get better, bounce from doctor to doctor, and are often misdiagnosed because doctors often don't have a framework for looking at root causes and functional medicine is this framework for looking whether it's heavy metals which I've had, or Lyme disease which I've have had, or Babesiosis which I've had, or Mercury which I've had, or mold which I've had. These are the things which are typically ignored by traditional medicine. Even diet for God's sake, which is more obvious, is often also ignored as a root cause of so many chronic illnesses. Dr. Mark Hyman: I think what you're talking about is that there is hope for people who suffer and who struggled if they can figure out how to get to the right person, which is not always easy, but to even advocate for yourself and say, "Look, I've got this problem, and I'm not giving up and I'm going to go dig until I find what's going on." And yeah, it could be a number of different things from a perspective of causes that can cause the same syndrome. So you can have rheumatoid arthritis, but it could be heavy metals, it could be gluten, it could be Lyme, it could be Bartonella. It could be all kinds of things, but we basically just lump everybody into the same category. "Oh, you've got rheumatoid arthritis," or you've got this or that disease. And we go, "We know what to do." We give you the drug for that disease, but it doesn't really speak to the cause. And that's really what you guys have been talking about. It's so refreshing to hear you talking about that. Dr. Mark Hyman: So, Dana, I want to jump to you for a minute. You got sick and you also developed a Lyme induced heart failure and you're a pretty young woman. You talk about how you got a tick bite and a rash, and everything went downhill from there. And you went from doctor to doctor until you found Dr. Phillips and got treated. So tell us about your story and how you ended up being treated by Dr. Philips and what happened to you and how you got better. Dana Parish: So, it was the summer of 2014. I was truly at the prime of my life. I just signed a brand new deal with Sony and just wrote their songs for Celine, and I was supposed to be traveling all over the place. I was incredibly happy. So I say that because when doctor starts saying it's in your head, or you're making it up, or you just want attention. Those kinds of things are absolutely insane to me because so many people are like me where they get really derailed at the prime of their lives and nobody would make this stuff up. It's absolutely devastating. Dana Parish: So, I got a tick bite. I saw the rash. I got it within five days I caught it because I knew when I got back from New Jersey and got back to Manhattan where I lived and I saw it. I was lucky that I was in the minority that saw the bite and the rash on my shoulder. Most people never see it. And many strains of Lyme do not produce a rash and many other tick-borne infections produced no rash. So that's an important thing for people to know. I went right over to urgent care. I knew it was Lyme. They knew it was Lyme. They gave me three weeks of doxycycline, an antibiotic and said, "You'll be fine. Go on with your life." They also told me not to Google Lyme, and then I would get scared, and that I don't want to be a crazy Lyme person. That was a clue that something really weird was going on. Dana Parish: I had no idea that this a very common ubiquitous infectious disease that drives a pandemic of illness was a political hotbed. I had no clue. So I do take the doxycycline. I try to move on with my life and three months later I wake up all hell broke loose. The first symptom was that my breasts had swollen overnight. I had all these fibro cystic changes and extreme pain. I went to the internist. She panicked. She sent me to an oncologist that day at Mount Sinai. He ruled out cancer. He agreed my breast was swollen and he agreed this was weird, didn't know why. He just knew it wasn't cancer. He sent me on. I went to go on to have fibromyalgia exercise induced incredible weakness. Dana Parish: There was a little gym in my building. I did my same lame workout that I do all the time. And just one day, my arm stopped working in the midst of all this. Literally couldn't lift a fork, couldn't feed myself, couldn't walk my 29 pound dog. And I went on to have incredible body pain, brain fog, visual disturbances, anxiety, depression, intrusive suicidal ideation, where I literally couldn't stop thinking about jumping out my window, but I didn't want to, but I couldn't stop. Dana Parish: It was like a monster took over my brain and my body. I went on to see three infectious disease doctors, tons of internal medicine, and the oncologist in sports medicine, and nobody had any answers. I would ask them, especially in the ID guys, "Could this be related to the tick bite?" No. "Why not?" "Because you took the three weeks of doxy and it's cured 100% of the time and they test too with doxy." Okay, that's actually totally not true. The other reason that one of them gave me, this is my favorite. This well-known doctor at NYU said to me because I went to medical school. So I'm like, "Well, ticks, carry other infections, too. Is there anything else?" I was pushing them. At some point I said, "Do you want to test me for inflammatory markers like anything?" He goes, "Oh, that's a pretty good idea. Okay. Well, this is my third visit with you. Are you kidding me?" Dana Parish: So, I went on to have this horrible experience until December when I went into heart failure. And then everybody really got serious, really believed me. I mean, I do think some of them thought it was in my head because I had so many weird disparate migrating symptoms that doctors are... When they don't understand something, they put you in the psychiatric bucket. That's a theme, I think. Of course, you know that very well. When you have these things, you do feel crazy because nobody can give you any help. And also the fact that it's changing all the time and every day, it really feels crazy. So then in December I went into heart failure. My ejection fraction was 40%. Under 50 is considered a heart failure for people who don't know. I mean, I was so healthy before all of this. Dana Parish: So, then thank God. I had a friend who knew about Dr. Phillips and seen him testify at some hearing and knocked it out of the park and said, "You got to go see him. He's brilliant, and I think he's the only person I would see if I was in your position." So I went to him and he saved my life. And within two months of seeing him, my heart failure totally resolved. He did talk to the Mount Sinai cardiologist who had been very concerned about it, did take my heart failure seriously, just didn't know the cause. And Steve really educated him about Lyme carditis. He didn't really even know very deeply about it. He was interested and he was educable. He was the only one, but he was, and I really appreciate that. Dana Parish: But I was treated with a rotating course of antibiotics, antimicrobials, I did a Chinese herbal protocol as well called Zhang protocol. There are plenty of them, of different Chinese medicines you can take. That was the choice I made because I lived in Manhattan and it was in the city and I could see them. Anyway, Dr. Phillips really came in and got me better. It was a miracle. Dr. Mark Hyman: Yeah. Well, I hear this story so much [crosstalk 00:20:13] that people often suffer and they really struggle with trying to figure out how to get the right treatment. But I think what you're speaking to is they need to think deeply about rethinking medicine and rethinking how we approach disease based on root causes. One of the things I want to jump into with both of you and you talk a lot about these kinds of things in your book, Chronic, which is great. It's called the hidden cause of autoimmune pandemic and how to get healthy again, and it's available now on Amazon everywhere, and people should get a copy. If you've been struggling, this is going to help you understand what's going on and maybe guide you to the right resources. Dr. Mark Hyman: What really is going on is there's these chronically infections with clearly the tick infections, which are just Lyme, Bartonella, Babesia, Ehrlichia, and there are lots of varieties of each one of these. So, they're often hard to detect. The testing is a little bit outdated, as you mentioned, Steven, and I just wondered if you could speak a little bit about the testing and then I want to jump into talking about COVID and COVID and latent infections and autoimmune disease. Because I think it's a topic that people are talking about a lot, and I think people don't understand what that means, the long haul COVID. Dr. Steven Phillips: So, the many infections do have an unfortunate commonality is that they're fastidious. It's a term that microbiologists use to describe infections that we can't isolate from animals and people that have the infection. So Lyme is probably the best studied of all of them. If you inject Lyme bacteria into a dog and then let the dog get sick and then take the dog's blood sample a month later, and you know the dog has Lyme, you can't find the actual bacteria in the blood. It's the same for all the animals studied and same for people. And with the animal studies, they can cut them up and find that there's still Lyme bacteria alive after the same treatments that are supposed to cure it in humans. And in humans, they don't cut us up, thankfully. And that's the main difference in terms of the animal data and the human data. But they've isolated this bacteria, even though it's so hard to isolate, they've still isolated from about 75 patients, human patients after up to two years of antibiotics. Dr. Steven Phillips: So it could be a really, really stubborn bacteria, but believe it or not, it's easier to treat in my experience than some of the other infections, particularly Bartonella, Tularemia is really rough sometimes. And so can Coxiella, Q fever is very, very difficult. And then the parasitic infections that people never talk about because we're told to ignore them in med school, but I do have a broad range of a panel, a blood test panel for antibodies against nine different parasites. whenever people come in and it's shockingly common. The interaction between parasitic infections and bacterial ones is such that the parasitic infections facilitate and perpetuate the bacterial ones, because they're a bit immune suppressive. Dr. Mark Hyman: And so you're getting also viral infections that underlie some of these chronic things too. And right now we're seeing this viral infection COVID and we're seeing even more scary to me than the actual COVID because most people recover from that is the long holler COVID syndrome, which we've talked about on the podcast before. Essentially it's a chronic fatigue-like syndrome, and when the first SARS infection decades ago, about 40% of people who survived, and it was a much more lethal infection, 40% of people who survived got chronic fatigue at three years. And we're seeing this now. We're seeing people who have not even been that sick. People who are young and healthy who got it and recovered and just never get better. So can you talk about what this long hauler COVID syndrome is, how it relates to the underlying potential other factors that are going on with people like chronic infections? What do we know? What do we not know? And what's your experience in treating some of these patients? Dr. Steven Phillips: So my experience in treating just regular COVID, acute COVID has been overall very, very good. And patients have responded to things like doxycycline, ivermectin, and a bunch of herbals like vitamin D, vitamin C, zinc, [Corson 00:24:02], and Bromelain. However, my experience with long COVID is a little bit different. I only have one true long COVID patient. She's a person who didn't call the office for her acute COVID situation. She called a primary care doctor. They said just take Tylenol. And then three months later, she called 11 doctors in desperation. I was doctor number 11. I actually gave her Ivermectin and she turned around in 24 hours. Dr. Steven Phillips: I do have one patient I actually just spoke to today who had a mild case of COVID. And after that, her Bartonella symptoms are very much flared up. And we're trying to figure out, is this still virus persistent in her body? Is that what's driving things or is it like the apple cart was just upset immunologically and her prior Bartonella is flared up? It seems to be actually the latter in her because she's responding to the antimicrobial therapies she did before with Herxheimer reactions, which are these dial-off reactions, and all these things that all got worse since her COVID are responding to the same antibiotics that I would treat somebody with Bartonella. Dr. Steven Phillips: So I'm wondering if some of these long COVID patients that people don't understand that we think about these infections that they always cause illness, but the majority of these chronic infections that we're talking about today don't make people sick. Or if they make them sick, they make them mildly sick and they never really get a diagnosis. What happens when you come with a bad viral insult? So, before COVID came along, I would have people who had a really bad flu and then they were never the same. And then they develop chronic fatigue like picture and we do an evaluation for chronic infections, find some, treat some, and get them better. Dr. Steven Phillips: I don't think it's that dissimilar. I think COVID is a terrible, terrible virus, but I think it has the same common features with other viruses that I could just, like I said, be a big shock to the immune system. It's ridiculously common how many of us are walking around with chronic infections we just don't know about that. We never get diagnosed. Dr. Mark Hyman: How do we then detect this long hauler COVID because I think people are curious about, okay, well I'm not feeling well, I've had COVID, I want to get better. I don't know what to do. What are the kinds of things you're seeing as one, any diagnostic information you're getting on these people, and two, what are you finding works clinically to treat these people and help them get better? Dr. Steven Phillips: Well, it's hard to find the virus. In the studies, the people that have had persistent active virus has been basically, GI-tract biopsies and biopsies the olfactory bulb near the brain. So it's not just... Your listeners should know it's not just a go for a nasal swab and when it's PCR negative that rules it out. So the virus can persist and hard to biopsy places. And these tests are available like routine drive-through centers. It's really like a research test. So doctors don't have the ability to do that outside of a research setting. In terms of looking for these other infections, any doctor that's educated about these can look for them. I do 99% of my blood tests for patients at chain labs like Quest and LabCorp. And it's a long litany. It's like 17 tubes of blood, but we cast a broad net and we try to find targets that are treatable. Dr. Mark Hyman: In terms of the clinical symptoms people are having and the treatments that are working, can you tell us more about your thinking about how we should be approaching this? Dr. Steven Phillips: So there's a subset of long COVID patients that have some common features. The breadth of symptoms is really, really, it's incredibly broad, and there were some things that I'm hearing about in long COVID patients that I see in my chronic illness patients. And they're very weird symptoms like a sense of internal vibrations. I don't know if you've had patients who've ever complained of that to you. But this is a common complaint among my patients is something long COVIDs are complaining about, long COVID patients. So as soon as I heard that, I started getting very, very suspicious that, wait a second, is this really flaring up underlying infections that we see? Dr. Steven Phillips: And in my one clear long COVID patient that I've seen it's she responded to ivermectin, like I said overnight, and she basically had chest pressure and pain with breathing. And that was her persistent manifestation of COVID. It's not something she ever had with her prior illness. She was a patient who was treated over a year or so before. She'd been fine since I treated her, got COVID then had this chest pain. So she developed a new symptom and very quickly responsive to ivermectin. So, ivermectin I don't know if you've talked about ivermectin on your shows before or no? Dr. Mark Hyman: Yeah. [crosstalk 00:28:37]/ Dr. Steven Phillips: But ivermectin is antiparasitic, it's a really safe drug. Yeah. So, I've had experience with it way before COVID came around because I used it because I do, like I said, evaluate and treat parasitic infections, and I've also used it as an immune modulator. Ivermectin has this really cool many effects in the body. It gets rid of abnormal inflammation and it gets sort of abnormal immune suppression at the same time. So it has immunologic benefits for people with inflammatory illness, but also in the case of COVID has direct antiviral effect. So, if I have a long COVID patient, I mean, I'm going to offer them something that's going to cover the virus, and I'm going to evaluate them for the other chronic infections that COVID could have stirred up and what we find we'll offer treatment for those as well. I would take a dual approach. Dr. Mark Hyman: Yeah. And are people getting better, you think? Because I think a lot of people are worried about the long haul COVID syndrome and people not actually recovering fully from it. Dr. Steven Phillips: Well, I've been booked out for so long. I mean, that we haven't even... Long COVID patients are calling the office and I'm just gathering data on one of my patients now who had COVID. Like I said, limited experience in treating long COVID patients. So I'm going to start accepting long COVID patients and evaluating them the way that I said using this dual approach to cover the possibility of persistent viral stuff going on and also the possibility of flaring up other chronic infections like Lyme and Bartonella and other chronic infections that people may never have heard about. Dr. Steven Phillips: I do think that I can help patients, but I don't have a big wealth of experience to draw from. I don't know how many long COVID doctors are there that have a big wealth of experience on what's working because from what I'm hearing from the long COVID community because we're partnered with Survivor Corps, which is a large group with long COVID patients. And so far there's very limited trials of stuff to get these patients better. None of the doctors are really taking it by the horns, so to speak and really helping these patients. Dr. Mark Hyman: We've got a clinic at Cleveland clinic called the reCOVer, R-E-C-O-V, right? Like for COVID reCOVer clinic. It's a multi-disciplinary clinic around how to recover from COVID from long hauler syndrome. So I think that there's interesting things happening around the academic centers. We're looking at all kinds of options. And I do think functional medicine approach is really powerful. I think for people listening, there's a lot of approaches to chronic infections, antibiotics, herbs, lifestyle, and more. Some of the other things that we've talked about in the show like ozone and hyperbaric oxygen therapy, hyperthermia, and another approaches can be actually also very effective. And clinically I find some of those really helpful in resetting the immune system and resetting the way in which your body handles infections, even directly killing infections. So, I think there's a lot of tools out there and options. Dr. Mark Hyman: We did a podcast from Sanoviv where I went and I personally had Bartonella. I was really persistent. I was having night sweats, still fatigued. I was functioning pretty well, but I still really struggled. And people who do while they're walking wounded are often the ones who have good lifestyles, but they still have this low grade stuff. If you have a crappy lifestyle and you get this you're in trouble. It's really bad, but I got the chance to do hyperthermia, which was an interesting treatment. That's not available in the United States. It's in Europe and in Mexico. I was able to put my body to 170 degrees. And after that and giving me antibiotics during that time, during the peak of the fever my systems start to respond and shift and recover. Dr. Mark Hyman: I just talked to on the patient who had Parkinson's disease, who also had Babesia and Lyme and many other co-infections and really found the same thing. We treated them with lots of antibiotics and herbs and things over the years. But finally we got them to do treatments of ozone or hyperbaric oxygen and hyperthermia and he went to Sanoviv and it was really quite remarkable. So it's not available to everybody, it's expensive, but for people who are really struggling, there is often a way out. So Dana, tell us about your perspective in terms of interacting with your own health and the medical community and the struggles you've had, and what you're doing to change how people are shifting the perspective of how we can get better. Dana Parish: Well, one thing that I should've mentioned which speaks to this is that when Steve worked me up, he found another infection, Bartonella that was also driving my symptoms. So my Lyme was definitely undertreated. There was no question. Three weeks of antibiotics is definitely not enough for many, many, many people. The data is clear. So I should say that, but the fact that nobody looked for anything else is crazy to me. And when he treated both of those infections, all my symptoms went away, my psych stuff too. So I think that that point needs to be made. Dana Parish: I think a lot of people suffer from anxiety and depression, along with their "autoimmune diseases." And people tell them, "Well, you're anxious because you have fibromyalgia or because you have RA." No, you're not anxious because you have those things necessarily. I mean, yes, they suck. It's depressing, but there's a brain component here. There's a neurologic component just like we're seeing with COVID. And I think it's a lot easier for doctors now... Well, not all of them. Okay. So, they're coming around to the fact that infections can cause a humongous multisystemic illness that lasts and lingers, and that is driven by a stealth chronic infection. Dana Parish: There's so much for them to learn. If they've been paying attention to Lyme for the last 30 years, we wouldn't be in this horrible mess with COVID in my opinion, with long haulers. Because I think it will be very obvious that there are chronic infections driving some percentage of these people's symptoms. So it's a bit crazy-making to me to watch this all being predictably played out the way it is where we're talking about immune suppressants already, and they're not talking about antivirals. These things need to be put on the table. Dana Parish: But in terms of my interactions with the medical community and my advice is just if I didn't advocate for myself and if I didn't trust my intuition, I knew they were all wrong. Yeah, it made me feel badly that I wasn't being taken as seriously as I felt I should have been. It made me feel badly to have the sense that people thought it was in my head, but I didn't care that much because I knew they were wrong. And I think everybody has this inner voice that tells them this is the wrong path. This doesn't make sense, but most people don't follow it. They need the confidence. So if I can be a guiding light in that regard and just tell people to keep going, and go move on from doctors that aren't believing you and they won't look at data or won't listen to other stories that are similar to yours, stories like mine, where people were covered. Dana Parish: I say, move on. But I also feel very strongly that you need to bring somebody to an appointment with you because when you're really sick like this, you need somebody to advocate, ask questions, write down information because you forget a lot of stuff when you're in this state. I mean, I just say, as you just said, don't give up. There's a lot of ways to skin a cat and this is my journey, but there are many, many other people I know that got better in various ways. Just look for the root though. Demand the root cause answer, demand it. If you don't find it, that's what you got to keep going for. That's my opinion. Dr. Mark Hyman: Yeah. The challenge a lot of times, Dana, and Steven, you know is that in traditional medicine we're not really trained to look at root causes most of the time. Sometimes we do, but most of the time we don't really have a framework for thinking about chronic complex illnesses. You got acute illness, you got acute infection. Okay. We'll say is this bacteria? We'll treat you, we'll figure out the cause and that's fine. But for these latent infections or chronic infections or blatant issues, whether it's mercury or mold or Lyme or whatever people are often struggling for decades. There really is a method of figuring this out and really that's what we do at Cleveland clinic and at the Center for Functional Medicine, at my practice, the UltraWellness Center, it's what you do, Steven. And a lot of doctors on the country are moving towards this kind of medicine, and people call it functional medicine, whatever you want to call it, but essentially, it's a new framework for thinking about disease based on treating the body as a system, about getting root cause, about understanding the interconnections between these things, and thinking out of the box. Dr. Mark Hyman: I mean, just the idea that you can cure heart failure by treating infection. That's a kind of an interesting idea. We know that viral infections affect the heart and cause heart failure, but we never really... And we even know from the literature that Lyme does too, but it's just sort of a blank spot. Doctors don't pay much attention to it. So I'm really grateful for both of you for taking this on, writing this book, Chronic: The Hidden Cause of the Autoimmune Pandemic and How to Get Healthy Again. There's a great chapter in there on COVID and how we need to think differently about COVID and autoimmune disease and chronic long hauler syndrome and some of the stuff we're really struggling with. What advice would you give people who are just struggling, both of you, in terms of how to advocate for themselves, how to get the support they need, how to find someone who can help them and how to keep going? Dana Parish: Okay. I would say that I like functional medicine. So, if you can't get answers from traditional medicine, then I would go towards a functional medicine route. I'd go to integrative doctors. I'd find Lyme doctors. I'd find somebody that's willing to listen and work with you that way. Dr. Steven Phillips: Yeah. I mean, it takes a village. You need diverse views because you never know what the next piece of information will provide. I failed so many therapies before I got well, and people always ask me, "How come you didn't give up?" Because I knew that what that was driving it was infection. There was tons of evidence that it was. And I say that to people all the time. It's very easy. It's very disheartening. It's like who gives up first? You or the chronic illness? And so, it takes a village, and I encourage people to gather a team that can support them the way they need to be supported. Dr. Mark Hyman: I think it is persistence. I mean, I remember being sick and I don't know if this is your experience or what you see, but it's often not just one thing. People can have Lyme, but they might have many other issues that also need to be addressed. And if we just do one thing, you may not get it all. So for example, I developed Mercury poisoning as my first insult, but then also got Lyme disease, which I didn't know probably for over a decade or more, which sort of prevented me from getting fully better. Then I lived in a house that had no mold in it that I didn't know, and another house that had mold in it. And finally got really sick from the mold. So I had Bartonella, I had Lyme, I had mold, I had mercury, and often you see a lot of patients who have multiple factors that are driving their disease, not just one. And you can't just often just treat one, you have to deal with all of them. Dr. Mark Hyman: The other things do suppress immunity. For example, heavy metals will suppress your immune system are more likely to cause autoimmune disease, and soaking things like mold. Or it could be your gut, or it could be food sensitivities, or a whole bunch of different things. So part of the trick is to understand how to address all these factors using the right kinds of support and tools, which I think you'll find in your functional medicine. And people listening, they can certainly go see you Steven or see us at the UltraWellness Center or Cleveland. But also there's a lot of incredible doctors around the country. You can go to ifm.org and go find a practitioner. Dr. Mark Hyman: Now, not everybody's going to be equally trained or equally knowledgeable or equally as good as being a detective. Not everybody's Sherlock Holmes, right? But most can help get you started and figure out what's going on and point you in the right direction. I encourage people to not give up because chronic illness sucks. And I can tell you from being there. I know, Steven, you've been there, and certainly Dana you've been there. Any last thoughts or words of wisdom for people listening about how to think about keeping healthy and getting their lives back on track if they've been sick? Dr. Steven Phillips: Yeah. Just have faith in your body's ability to heal. It is like you said, Mark, it's a multi-hit process. We can sustain a lot of stressors, and it's like the straw that breaks the camel's back. At some point it just becomes too much. And that was something that I had to really convince myself. The days of my near death experience are behind me and I'm a fully functional person again. There's a lot of trauma from going through a life-changing illness. Again, we also, there's a whole section of the book about EMDR and other trauma therapies because it's very hard to recover once you're physically better to even recover psychologically from that trauma. So I just want to tell people that you have to treat every part of them. The body, the mind, and then look at this, like you said, from a multi-hit kind of scenario that it's not just to be, it's usually not one infection, and it's usually many other environmental exposures besides infection. Dr. Mark Hyman: Wow. Well, this has been such a great conversation. I know people who are listening hopefully can get a little bit of hope and encouragement to get your book. It's really a great addition to our understanding of autoimmune disease and chronic illness, and even COVID. It's called Chronic: The Hidden Cause of the Autoimmune Pandemic and How to Get Healthy Again. It's available now everywhere you get your books. And I hope you all love this podcast. If you know anybody with chronic disease or you've had it yourself, please share maybe how you've gotten better, leaving a comment. We'd love to hear from you. Subscribe wherever you get your podcasts, and we'll see you next time on the Doctor's Farmacy.