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

0:01What 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. We've been at this for 20 plus years. We have slowly filled up our toolbox in such a way that we really can help the majority of people who are really sick.

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1:32Dr. Mark Hyman:I've also been reaching for their all-day tea a lot lately. It's soft, it's lightweight, and it still feels comfortable even on long, hot days. Sometimes the small things in your life can have a bigger impact on how you feel than most people realize, especially when it comes to comfort and sleep quality. If you're looking to upgrade your daily essentials, head to CozyEarth.com and receive 20 % off. All right, 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.

2:10Dr. Mark Hyman: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 that gets sort of dismissed by traditional medicine, or it gets ignored, or that 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 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.

2:48Dr. Mark Hyman:And 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 moldy 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 15-mile bike ride this morning, almost 67. I feel great. My time's about the same as it was 10, 15 years ago on the loop. So I think, you know, the reason I share the story is because I think there's hope out there and you provide a lot of hope.

3:25Dr. Mark Hyman:So, Neil, why don't we start out by you kind of framing the issue of 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, you know, that this is just, you know, psychological. And why is medicine sort of missing the boat on this? 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.

4:04He 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 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 it's in your head. There's no such thing as Lyme disease. There's no such thing as mold toxicity. And we have helped thousands of people recover their health by knowing that there is another model, there is another way.

4:54But another part to your question is we live in an increasingly toxic world. it is now known that there are 350 ,000 new chemicals in our environment in the last 70 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 So people are rolling out 10G 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 100 years ago no one had to deal with.

5:43And 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. So I think that's what's happening.

5:59Dr. Mark Hyman:And it's really tragic. It is tragic. And I don't know if you ever experienced any of these problems yourself, Neil, but 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, I had severe fatigue, brain fog, cognitive issues. and you know I developed 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 30 years ago and I think that a lot of people out there listening have these issues whether it's you know chemical sensitivities or histamine responses we call MCAS now is you know basically an advanced form of like you know, histamine intolerance.

6:51Dr. Mark Hyman: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. And 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 start 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, and help them understand what's happening and kind of guide them? Well, the first thing I always look for is root cause. What is the primary thing that's making my patient sick?

7:28Unfortunately, there could be several root causes in your case. And I remember talking to you when you were really ill with the mold toxicity.

7:36Dr. Mark Hyman:Thank you, 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 what 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.

8:33And they can 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 going to be not making any progress.

8:56Dr. Mark Hyman:I agree. And I think, you know, 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 You know, Lyme, Babesia, Borrelia, Bartonella.

9:35Dr. Mark Hyman:I mean, Lyme and its co-infection buddies. Yes. I knew you meant that. I just wanted to clarify. Okay. Yeah, yeah, yeah. Because not every person has got a flu to 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 20 years ago called The Right Order of Things, which is exactly this. You know, 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.

10:10Dr. Mark Hyman: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? By the time people reach me, many of them were like you at your worst, in 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 going to get worse. And that order has to be figured out. For most people, starting with mold toxicity is the right order. So one major reason for it, and I'll give you several.

10:53One 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, people get either completely well, which means we don't have to go down the lime 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.

11:44So 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.

12:13Dr. Mark Hyman:You talk about the cell danger response. That's what you're talking about, right? 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 mold. 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.

12:54But I've had countless patients spend years working on Epstein-Barr or mitochondrial dysfunction, methylation dysfunction, and getting nowhere.

13:05Dr. Mark Hyman: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.

13:51And that is not psychological. You can't just decide, oh, I'm going to 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. That's a lovely thing you're doing for me.

14:36I can't deal with it until I'm safer. So that's how I conceptualize the order in which we may trade.

14:45Dr. Mark Hyman:I know, I know, another doctor talking about protein, but stay with me for a second because what matters isn't just how much protein you eat, it's actually whether your body can actually use it. As we age, we naturally lose muscle and become less efficient in absorbing and utilizing protein. There's actually a term for this, anabolic resistance. And that's why I add Perfect Amino to my smoothie every morning. It gives you all nine essential amino acids in a highly absorbable form that supports muscle protein synthesis and help maintain muscle and bone health as you get older. And unlike many whey proteins can spike insulin levels similar to sugar, Perfect Aminos doesn't.

15:19Dr. Mark Hyman:Plus, it can help you hit your protein goals without adding a lot of unnecessary calories. So if you want to learn more, head to bodyhealth.com and use the code Hyman20 for 20 % off your first order. That's bodyhealth.com and use the code Hyman20. I put a lot of consideration into what I eat. We have to eat real whole foods to stay healthy, and that is why I love my clean seafood box from Seatopia. It arrives blast frozen at my house. It's lab-tested for microplastics and mercury, and it's packed with a variety of seafood that's full of bioavailable omega-3s. You get the best of seafood's nutritional properties without the cytotoxins, sadly now often found in our oceans.

15:55Dr. Mark Hyman:My favorite is the Seatopia king salmon, which is full of bioavailable EPA and DHA, and you get so much of it in a single meal that it actually beats what most people get in a week's worth of supplements. And honestly, it does taste so much better than a pill. Get your first box at Seatopia.fish and use the code HYMAN for free shipping. Yeah, it's tough. I almost died from mold. I'm in this barn where you can see the background and I as 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 the house kind of smelled a little moldy I was like oh maybe something's going on I checked it out and sure enough it was full of mold I'm I moved out but um I ended up getting this cascade of things that happened where I had a root canal removed, I had an antibiotic, gave me C.

16:45Dr. Mark Hyman:diff and my whole system collapsed. And, and I went into this massive inflammatory cell danger, catastrophic catabolic state where I, 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, and it was tough to get out of that. Um, and I think, you know, for some people, um, you know, the question is what are the, what are the right levers and where do you start? and for me i 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.

17:37Dr. Mark Hyman: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. And I think, you know, the phospholipid exchange, I find really helpful too, which is a whole different approach that was developed by Patricia Kane and others that uses high doses of phospholcholine intravenously along with glutathione and methylene nutrients and other minerals to help mobilize the toxins. And I found that extremely helpful. And I find it helpful for a lot of patients. So there's a lot of things that are in the toolkit for people, but I think what you're talking about, Neil, is that you really have to have the right map for people and really think properly about this.

18:17Dr. Mark Hyman:Maybe we can kind of 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 being tolerant of things to being intolerant? 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.

19:01And 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. Mold 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.

19:51You 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.

20:06Dr. Mark Hyman:Yeah, like a mold dog. I have that. I can walk into a room and I'm like, oh, moldy. Well, dogs, we know, have a sense of smell a thousandfold greater than ours. But even humans can develop some of that when their limbic system gets flied enough. And I knew you when you had lost 35 pounds, and you do look much better now than you did back then. It's good to see. It's amazing the body's recovery capacity. And 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 to the field.

20:54Dr. Mark Hyman: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, which includes EMF sensitivity, environmental toxins, COVID, long COVID. I think this is really important. And I personally use the book because I think it's such a detailed resource for understanding these chronic illnesses and for giving hope to people who really struggle. So I would add to that, I wrote a book called The Sensitive Patient's Healing Guide, which focuses on the sensitivity component.

21:29And 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 and live with it. My message is, no, you don't. We can fix that. For people who have 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. So I want to really emphasize the hope that you're referring to, which is, you know, we've been at this for 20 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 really sick.

22:24Dr. 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, you know, it'd be helpful to kind of, you know, get your perspective because, you know, this cocktail of chronic kind of persistent illnesses. And I 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, you know, traditional medicine doesn't really sort of acknowledge these conditions. The diagnostics are really not used.

23:05Dr. Mark Hyman:What are the diagnostics that you use to help figure this out? And then let's talk about, after that, some of the, you know, the right ways of approaching this from a treatment perspective. For mold toxicity, there are four labs that will help make the diagnosis. Three of them measure mycotoxins in the urine and one measures 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 my experience, and I can give you reasons why that.

23:41Dr. Mark Hyman:So you think, yeah, because people dismiss it. Oh, this is just toxins from food. It's not really real. 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. So 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. So you're saying urine mycotoxins, and then there's also a whole field of, you know, mold-related illness has a phenomenon he talks about called SIRS, where there's a lot of biomarkers that are used, including MSH or C4A or TGF-data-1.

24:31Dr. Mark Hyman:These are like blood tests that you can get. Are they useful? Are they helpful? Do they not matter? 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 an excruciating discussion of the differences, that's going to be available, and I'm really happy that we've been able to do that. All those tests that you're measuring, they're blood tests, TGF beta 1, C4A, MMP9, VEGF. They're indirect measures of inflammation.