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

19:16And I found with a lot of these autoimmune illnesses, I had a patient recently with rheumatoid arthritis, true rheumatoid, CCP positive rheumatoid factor, but he had migratory joint pain. So that's why the methotrexate wasn't working is we had to treat his Lyme and he had drenching night sweats and he was like 40. And I said, oh, you're in menopause. He didn't get the joke initially, but it's like it was Babesia, of course, right? We treated it. And now the autoimmune disease was much better. So he had a true autoimmune illness, but then I have these other people, and you said it before, these autoimmune markers, they're showing up.

19:47The Lyme is causing antidopanergic antibodies, antithyroid antibodies, anticardiolipin antibodies, antimyelin antibodies. It's causing this auto... So people come in with these autoimmune illnesses, but it's Lyme causing molecular mimicry. Your immune system is attacking the bug, right? The flagellar, and it's causing these autoantibodies. It's not an autoimmune illness. It's the bacteria and the toxins that are combining to cause this type of inflammation.

20:11Dr. Mark Hyman:Just for people listening, when you say Lyme, you mean the whole spectrum of tick infections. Yes. Which is a whole, which is doesn't... Right, it's never Lyme disease anymore. I call it the three Bs, Borrelia, Babesia, Bartonella. That's one of the chapters in the book because these three are showing up in the vast majority of people at this point. So the microbiome stuff is a big thing too, and leaky gut and food sensitivities. What did you and I know about short-chain fatty acid bacteria years ago, right? Driving inflammation. I mean, I take prebiotics, probiotics, and postbiotics every day because I found out that the microbiome is so important from everything from autism to Alzheimer's to autoimmune, right?

20:44You can't get around it at this point because of the gut-brain axis. So, you know, that's how I support my health. I, you know, do prebiotics and all of this every day.

20:52Dr. Mark Hyman:You got to feed your, you're not just eating for you, you're eating for your microbiome. Yes. Yes, of course. You know, you also said something in this long list of litany of diseases, which I think is worth doubling down on, which is all these conditions seem like separate diseases. They all have separate specialties. They all have separate experts that have to manage each one with all their separate cocktail of drugs. What you're saying here is that all of these have similar underlying causes. And if you treat those underlying causes, the downstream effects tend to get better without treating them directly.

21:22Correct. So that's a big aha for people. And that's the problem in medicine. The way we were taught is name the disease, throw the drug at it. But you didn't get to the root causes of why they were sick. You know, even in autism, I recently had a young patient, 12 years old. The mother had congenital Lyme and no one ever checked. And the boy was living in a very mold, toxic environment. So this kid at 12 years old, social problems, connecting, right? We gave him Dapsone combination therapy for treating the Lyme, treating the BART, pulled out the mold. The kid's brain woke up. Now, the kid had been sick for 12 years and everyone had given up with him, you know, regarding that.

21:57He had autism. There was nothing we could do. So, you know, we clearly need randomized, multi-centered trials and all of these things, right? There's no doubt. These are all, you know, anecdotal stories. But what the medicine says, what the science says, with over 2 ,000 references, by the way, you know, in ending chronic illness, is there are 16 factors underlying all of these illnesses. So no matter what you're calling the illness, if you're tired, if you're achy, if you have pain, if you have brain fog, if you have mood disorders, you can't just take SSRIs and say, right? I mean, you know, Bobby Kennedy Jr.

22:27is going after it right now with it to get people off of them. But if you have Lyman Bartonella driving your illness with your mood disorder and mold, it's not going to be enough. You've got to get to these root causes and even trauma. I mean, I have to do vague limbic retraining. You probably do this the same. We find that probably at least a third of our population has such severe trauma that even if I address these other causes of inflammation, If I don't do limbic retraining with the Annie Hopper dynamic neural retraining or primal trust or gopto-amygdala insular retraining, using the Apollo Neuro or the Neuropod, getting their vagal system and everything in order, they will not get better, right?

23:03It's resetting the autonomic nervous system. You've got to reset the autonomic nervous system. So that's why all of these 16 points are so important in these patients.

23:10Dr. Mark Hyman:And all the things you're talking about, all these diseases, whether it's dementia or autism or depression or heart disease or cancer or any of these chronic fatigue syndrome, all these things, they're all tied to inflammation. So autism is inflammation of the brain. Alzheimer's inflammation of the brain. I wrote an article years ago basically about how, you know, autism and Alzheimer's are very similar. If you look at these patients, they have a very similar profile of genes. They have very similar biomarkers that are abnormal. They have like very different manifestations. but it's very, very interesting.

23:42It's funny you say that because I just did a medical detective sub stack on it. The mTOR pathway, right? We're using, people using rapamycin and other things to get to it. It turns out that with autism and Alzheimer's, it's the same biochemical pathway, right? So they just don't have enough autophagy. They're not getting rid of their damaged mitochondria. They've got an ongoing inflammatory response. And if you give sulforaphane glucosinolate, broccoli seed extract to the autistic population, they did it at John Hopkins. A third of these kids, their brains work. And the same thing with the Alzheimer's.

24:11So you're right. Autism and Alzheimer's on a spectrum of neuroinflammation. Yeah, it's all neuroinflammation. And so instead of naming it, right, where is the inflammation coming from? And that's the whole point of endocrinical.

24:22Dr. Mark Hyman:Yeah, I think that's what Sid Baker talks about, the naming and blaming game. We name the disease, and then we blame the name for the problem. Oh, the reason you have joint pain is because you have rheumatoid arthritis. No, that's just a name that we give to people who have that kind of joint pain. It doesn't mean anything about the cause. It could be mold, it could be metal, it could be lime, it could be a million things, the leaky gut. You also talk about one of the factors being vitamin and mineral or nutritional deficiencies. Can you talk about that? Because people think, you know, we don't have malnutrition in this country and we're all eating plenty of food and what the big deal is.

24:47No, in the top six root causes of inflammation, what I call the, you know, rivers of inflammation going into an ocean of inflammation, number five is vitamin and mineral deficiencies. And what we're finding because of all the toxin loads is when you do not just serum minerals, and you know this well, I'll check magnesium. You need it for 300 detoxification enzymes. You need copper superoxide dismutase. I need zinc for, you know, phase one liver functions and inflammation. When we look intracellularly at the red blood cell zinc, the red blood cell copper, the red blood cell magnesium, we're finding up to 20 % of our patients are deficient, which means you cannot detoxify properly and deal with inflammation.

25:21So, you know, somebody may have, for example, a normal or slightly low B12 level, but their methylmalonic acid level is high. So yeah, we're finding a huge amount of vitamin mineral deficiencies. And a lot of this is because you're fighting these infections. You're dealing with all these toxins. you're depleting your system, including depleting glutathione. I don't know if you knew this, but I wrote the first article in the World Literature in COVID-19 in April 2020 on glutathione and how it helps with COVID. And what I didn't know at the time, not one of my patients died from COVID-19, not one, because I was blocking the first major inflammatory pathway I discuss in the book, NF-kappa B.

25:56We were giving all of our patients N-acetylcysteine, alpha-lipoic acid, glutathione. I didn't know at the time that the virus needs to lower glutathione to replicate. And I also didn't know that NAC was blocking von Willebrand factors, so they weren't getting microclots and dying from it. So I was giving them the right treatment. I just didn't know why at the time. And then we were stimulating the NRF2 pathway, opening up detox using curcumin tumeric, broccoli seed extract, resveratrol, green tea. by simply doing these things with a little bit of vitamin D, you know, some extra zinc. I was giving him immunotics, 3 ,6 beta-glucan.

26:30By simply doing these things with a little bit of low-dose naltrexone, one of my favorites also for blocking the third pathway, NLRP3-inflammosomes, not one patient died and only two were in the hospital. And I saw very few long COVID cases in my practice with it.

26:43Dr. Mark Hyman:Yeah, it's true. I mean, the nutritional deficiencies are quite significant. And I think, you know, with Function Health, the company I co-founded, we're doing, you know, now we've, I don't know, we've over half a million, half a million members. We've done over a hundred million lab tests. 70 % of people are deficient in one or more nutrient, not at the level you or I would think would be okay, but at the level of the lab reference range thinks is okay. Like a vitamin D of 30 or a ferritin of 16 or homocysteine of like 14 or like, so like the, the numbers that are even greater than that, when you look at what the optimal ranges are, is staggering and vitamin d you know should be over 45 the 30 is their cutoff so all the all within their cutoffs on the lab we're still seeing about 70 percent of the people deficient in one or more nutrients so you're right these nutrient deficiencies are so important and people understand that what they do is they basically keep the wheels of your biochemistry working and if if it's if they're not adequate then the system can't run and you get you know kind of like kind of rusting things just kind of locked down the last thing you kind of talk about in your six principles is sleep.

27:45Dr. Mark Hyman:But I'm wondering why you focus on sleep versus stress, because I think of stress and sleeping under stress. But you focus just on sleep. So it's interesting that I also found with sleep, same thing, the 16 C-memcence factors are underlying sleep. But in my population of Lyme, these people don't fall asleep. It takes hours to fall asleep. They keep waking up in the middle of the night. They sometimes have hypersomnolins. They're sleeping for 16 hours. They're not refreshed. I have patients who came in on Ami and Lunesta, God knows what, they still could not sleep. So, I mean, you know, when you don't sleep, IL-6, interleukin-6 is high.

28:19It's driving inflammation. But ultimately, we were even finding some of our thin young women had sleep apnea, like something I would never have expected to find. It wasn't just men with BPH, you know, that was causing it. It wasn't just menopause with low estrogen. We were finding multiple factors. And of course, stress is one of them, of course. But the problem is we were finding these overlapping factors that until I treated the Lyme and the BART and the mold and healed the microbiome, right? And dealt with stress. And I have a whole section under Ellis for Lifestyle and Meditation. I mean, you and I both know we're living very stressful lifestyles for most people.

28:52The sleep, I found that when people couldn't sleep, whether I treated the infections, I detoxed the mold. If the sleep was still off, I was having a tough time getting these patients better. But they were all interrelated, right? Because the mold was causing problems with it. The Lyme and Bartonella was causing it. sleep. Yeah. So it was all interrelated. It wasn't just, oh, I can't sleep at night. You know, why isn't my Ambien or Lunessa working at this point in time? So you're able to get people who couldn't sleep back to sleeping? Yes. Yeah. I mean, once the infections were treated, we detoxed the mold, the microbiome was treated, right?

29:21The mineral deficiencies. Once we started dealing with these first six rivers of inflammation, people were able to get to sleep a lot easier. Also, by the way, with the limbic vagal retraining.

29:30Dr. Mark Hyman:Yeah. Right. I mean, that was a key point in these people because - I don't want to get too far into it, but I think, you know, I did Ibogaine. I've talked about it on the show before. It's an incredible plant medicine that has powerful effects on neuroinflammation and on mitochondria and epigenetics. And in one study, they looked at MS and they looked at the white matter lesions, which was inflammation in the brain before and after Ibogaine and their symptom profile. and there were only two cases in that report, but they both had like a 70 % reduction in white matter lesions, which is unheard of.

30:05Dr. Mark Hyman:And they were able to get back to much more normal functioning. So I think, you know, there's a lot of really ways to sort of reset the system. It's fascinating that, you know, these plants and these other things, like some of the supplements can have these effects. Oh, absolutely. And in fact, you know, I recently published an article in the Journal of Alzheimer's Disease Reports. We can get to this just briefly about, I reversed, for the first time ever in the world, the most sensitive and specific biomarker for Alzheimer's, P-Tau-217. So again, we're dealing with neuroinflammation, but where did it come from?

30:36In my patient, it was coming from multiple MSIDs factors. It was Lyme. She had exposure to Babesia Bartonella. She had heavy metals. She had metabolic syndrome. She had food allergies. We need to treat it all. But interestingly enough, we were finding that when we treated the Lyme disease with the nine weeks of dapsone combination therapy, She was sick for 15 years, by the way, with positive rheumatoid factors, with joint pain, some cognitive issues, which she didn't think were bad, completely reversed PTAO 217. Now, what's interesting is that the Cochrane report, which came out about one week before my article got released, said, hey, we have no good things to treat Alzheimer's at this point.

31:11The article comes out one week later. And what I did is I proved the hypothesis, right? We're in the middle of an Alzheimer's epidemic where the NIH said that 42 % of people over 55 years old are now going to become demented. I mean, it is really frightening, especially when they say we don't have answers. So there was always, they looked at autopsy studies of Alzheimer's patients and they would find biofilms, amyloid, and phosphorylated tau in the brains. So there was an association, but they couldn't say causation. This is the first time I proved causation by completely reversing this biomarker, P-Tau 217, with this nine-week protein.

31:45And this woman was, by the way, was sick for 15 years. And the symptoms got better. Her symptoms, her joint pain got better. Rheumatoid factor reversed because it wasn't rheumatoid arthritis. It was from the Lyme bacteria driving rheumatoid factors. What about her memory?

31:57Dr. Mark Hyman:Did it get better? It also improved. She thought it was her meditation that was keeping her stable. And she noticed after she was done, it's like, oh my God, I'm so much clearer. By the way, I have a second patient. I just did the same. I haven't published it yet. We reversed his beta amyloid ratios with Dapsone. So here we have an Alzheimer's epidemic where I found that all 16 MSIDS factors are associated with it. The Cochrane report is saying, hey, we don't have anything good out there to treat. And the drugs that are used for it, lakanumab, denanumab, they lowered phosphorylated tau by 23 % in almost seven years.

32:29I lowered it by 63 % in nine weeks. And that was because it was the infection driving the amyloid and the phosphorylated tau. And unfortunately, you go to a neurologist, they're not even going to check you for Lyme disease or Bartonella mold when you have Alzheimer's disease.

32:43Dr. Mark Hyman:And it's important to find out. I mean, people think, you know, Alzheimer's is one of those things with nothing to do for it because of the bad drug, you know, debacle we have in terms of poor drugs and drugs that don't really work based on billions of dollars of research and hundreds and hundreds of studies. But what you're saying is using this approach, which is looking at root causes, looking at treating the whole system, peeling all the layers of the onion, you can actually start to see changes in these people. And I've seen the same thing in my practice. And Dale Bredesen, who's quoting a quote on your book, also has done this.

33:12Dr. Mark Hyman:And, you know, for us out there doing it, we sound a little bit like quacks because, well, we're reversing Alzheimer's. Well, it isn't really, Alzheimer's is just a symptom. It's a neuroinflammation of the brain. And so if you can reduce the load on the brain, it can improve. Same thing with autism or ADD or depression. You know, and Chris Palmer's done this work at Harvard with schizophrenia, psychosis, bipolar disease. was it's a trial published, I think the other day, on ketogenic diets. It was a randomized controlled trial for bipolar I and schizophrenia and psychosis showing reversal. So the data is really starting to emerge around this, and ketogenic diets work by reducing brain inflammation.

33:46Dr. Mark Hyman:That's how they work. Your work is so important on this, and I think that I want to kind of double down on what you've been kind of alluding to, which is this DAPSOM protocol, because you mentioned a few times earlier, what are you talking about, and what does this do, and how does it reverse Lyme? How does it reverse Alzheimer's? Like it's, tell us about what it is, how you discover it. Cause you and I worked together with many patients and often I would say, Hey, I got this complicated patient with these three ticks or this thing. What's the best drug protocol? And you'd kind of coach me through it.

34:12Dr. Mark Hyman:That's probably started that doing that 25 years ago. But this is kind of a newer iteration of your thinking on this. Cause I, I think a lot of the, you're, you're a part of the ILAD society and I was one of the founding members. Founding members. And, you know, you and I both seen people who've just been on years of antibiotics, on IV antibiotics, on heavy doses. And often they don't really get that much better. And I really worry about that approach. And I do too, by the way. And that's why I never use long-term antibiotics anymore. The real key point for me is about 10 years ago, John Hopkins researchers found out that Lyme was a specific type of a bacteria called a biofilm persistibacteria, like tuberculosis and leprosy.

34:50We knew that Lyme persisted, at least those of us who've been treating it for a long time, because there's a lot of medical controversies, but it's definitely a persistent infection in many.

34:58Dr. Mark Hyman:Meaning the traditional medical establishment doesn't quite buy chronic Lyme disease. Correct. They call it post-treatment Lyme disease syndrome. We don't know why people are sick. It's like, you should read the 10 articles at this point. Well, 10 I published and one by Tufts, where we shown reversal of all of these symptoms using dapsone combination therapy. So how did I come up with it? So when Hopkins discovered it was a biofilm persister drug, I remembered from Mount Sinai when I was, this was during the HIV epidemic, we would see these people come in with mycobacteria, amabium intracellulari and TB.

35:25I was used to using INH, rifampin, pyrazinamide. And I said, you know, I wanted an excuse to use these TB type drugs because they were specific for biofilm persister bacteria. I looked at the qualities of dapsone. So tuberculosis is one that's known in traditional medicine to be this, and that's why we use those drugs. Absolutely. So I looked at dapsone and it was, all right, it gets great penetration into the brain. Maybe I don't have to use IV drugs, which is true. I've never had to use IV drugs anymore since dapsone. It's amazing penetration in the brain. Number two, it blocks NLRP3 inflammasomes in the brain.

35:56So with Alzheimer's disease and autism and many of these different diseases, we know that there's an inflammatory pathway in the brain that gets switched on. Dapsone is an inflammasome inhibitor. So in a study by Lee et al with like three to 4 ,000 people over 16 years, he gave him a hundred milligrams of Dapsone. The rates of Alzheimer's were like this and the people who didn't take Dapsone was six times higher. So it's lowering inflammation in the brain, great penetration. It has anti-malarial properties. It hits Babesia. Not great, but about 25 % of the cases. It's used for autoimmune diseases.

36:28We talked about all the autoimmune manifestations of Lyme, right? And it's a biofilm persister drug. So it checked all the boxes. So I started trying it and I published my first article, 2016, on 100 patients on low-dose dapsone. Fatigue got better. Joint pain got better. Neuropathy got better. Brain fog. Headaches, it was the only thing statistically that didn't improve. But as I tweak the protocol over the last 10 years, I got it down to eight to nine weeks at this point. And it doesn't matter whether you've been sick for 20, 30 years. If you have Lyme without active Babesia Bartonella, without mold, this protocol will put about half of the people in remission from nine weeks of antibiotics.

37:04And it's not just Dapsone, it's a cocktail. It's a cocktail of drugs. So we found, and I did a study with Eva Shopey from the University of New Haven in culture. And by the way, this is a drug that was used for leprosy. It is a leprosy drug, right. It's been around for 50, 60 years, right? They also use it, by the way, for Bissett's disease and a severe autoimmune illness. And so what I found is in culture, every time we added a drug, like when we added doxycycline to dapsone, it lowered the biofilm persister. We added rifampin to doxy and dapsone. It lowered the biofilm persisters even more. We added Zithromax.

37:35So I came up with it because we found this four-drug regimen sufficiently lowered these biofilm persisters. And if you pulse it, you cannot get rid of the these persister bacteria by with chronic antibiotics, it doesn't work. You've got to pulse it. That's how you get rid of them. So we now do a nine week protocol. Which is not every day. Well, it's nine weeks continuously, but they're on four probiotics with 500 billion of these different probiotics twice a day, right? With Nystatin, very low carb diet. We don't see, I've hadn't, by the way, seen a case of C. diff on this in years. No candida as long as you're staying.

38:08And basically all the lab abnormalities of anemia and methemoglobin, they reverse within six to eight weeks off the protocol. So right now I applied for a randomized NIH trial with a double blind placebo multi-center trial. Unfortunately, it was turned down. So I now have to reapply. I know Bobby Kennedy Jr. is big about Lyme. He wants to do something, but whoever the reviewers were, but I'm so confident I submitted an R34 NIH grant because I know it's working at this point. But yes, it's a cocktail of drugs, but the beauty is all generic because I realized this is a worldwide epidemic where BMG Global Health said one out of seven people in the world have now been exposed to Lyme, right?

38:48So we're dealing with a massive epidemic of Lyme. And by the way, same time, massive epidemic of Alzheimer's. And nobody has put these two together at this point. And that's true.

38:57Dr. Mark Hyman:I mean, nobody's connecting the dots on that, but it's not that Alzheimer's is always this. No, no, of course not. And I think that's, you know, you kind of hinted in your book and my first book I wrote, just because you know the name of the disease, it doesn't mean you know what's wrong with you, right? Alzheimer's is a syndrome. Of course. And it's got many causes, and maybe a good cohort of those is tics, but it could be mold, it could be insulin resistance, it could be metals. Right, and look, even some of these drugs that are used out there, the anti-amyloid drugs, there may even be a place for them, but first, let's get rid of whatever the reversible causes of inflammation are.

39:27And that's not what the neurologists are doing, right? They're giving Aricept and Namenda and anti-amyloid drugs. We've got to get to the root causes of where the neuroinflammation is coming from, and that's what I'm highlighting in the chronic illness.

39:37Dr. Mark Hyman:Do we all take patients with that same combination? I do. So it doesn't matter what the infection. Well, the beauty of... Because before it used to be this regimen for this one, this one, for that one. Now you're saying everybody should get the same... Well, so if it's Bartonella, Bartonella requires a minimum of four two-week pulses of Dapsone, but it's only six days of Dapsone. We found with Bartonella, Bartonella is actually much more difficult to treat than Lyme. If you don't have Bart, I can generally get you better much easier within this nine weeks. But BART requires about two to three months apart, just two weeks of antibiotics, short pulse, actually 13 days.

40:08Separate. Separately. If you have Babesia, Mepronizithromax isn't working. The old drugs aren't working. So I have in my new book, under the three Bs, tefenoquin. Tefenoquin is a newer drug for Babesia. We mix it with malarone and herbs like artemisinin, Chinese skullcap, Japanese knotwood, acornia. We find that when we mix these herbs with tefenoquin and malarone, we're getting much better results for Babesia. So you do have to treat some of these infections, you know, differently and separately. But the beauty is, is we do have now some cutting edge approaches that are getting much patient, many of the patients better.

40:40Dr. Mark Hyman:And you also use, in addition to the dapsone, doxycycline, aminocycline, fampene, hydroxychloroquine, which is... And the reason for Plaquenil, by the way, is it alkalizes the intracellular compartment. So these antibiotics are more effective, helps with the autoimmune manifestations, even histacistic forms of Lyme, another form of the bacteria that exists. So it took me a long time looking at the biochemistry of the bug and the science and the biology to figure this out. And 10 years later, you know, I published 10 studies, Tufts, by the way, published one that showed that this combination of rifampin-dapsone cures Lyme in the animal model.

41:14So now I have a culture study, we have animal studies, and I have 10 published studies with around 375 patients retrospectively, all statistically significant. Fatigue, brain fog, joint pain, muscle pain, nerve pain, day sweats, night sweats, neuropathy, it all gets better from the protocol.

41:30Dr. Mark Hyman:And you also see it as methylene blue, which I thought probably... So tell us about that, because I think people hear about it, and people think, oh, they take these lozenges, their mouth gets blue. Well, they're using it for Alzheimer's, right? I mean, they're using like low-dose methylene blue as a mitochondrial supplement for Alzheimer's. So one of the side effects of dapsone is elevated methemoglobin. It's where you don't carry oxygen well in the blood. So we started adding methylene blue because many of our patients, about 90%, have Bartonella. John Hopkins, again, they published that if you do, for six days in culture, rifampin, zithromax, and methylene blue, it kills Bart.

42:02So when I was designing the protocol, I realized I needed methylene blue to not only hit the Bartonella, but to lower the side effects of dapsone. And it's got mitochondrial regeneration properties at the same time. And we do a mitochondrial regeneration when we're done with the protocol anyway for all the free radical oxidative stress. So yeah, the methylene blue is an integral part of the protocol. And we slowly go up to make sure people tolerate it.

42:24Dr. Mark Hyman:It's also anti-infectious. It is anti-infectious. They use it in the blood supply, by the way, to kill. I don't know if you knew this. No. In the blood plasma supply when they're treating for all the red blood cells they're storing. Really? Methylene blue is what's used to kill all the infectious agents that's in our blood supply. Oh, that's fascinating. So it's anti-infectious. It protects against the side effects of the DAPS zone, helps mitochondrial function, energy production. And it's hitting Bartonella at the same, you know, when, again, when I designed it, I was looking at all of these factors at the same point.

42:49And again, I've been doing this for 42 years, right? With all these thousands, it took a while to figure this out. You know, we're kind of there.

42:55Dr. Mark Hyman:I know. It's pretty, pretty crazy. I think it's, and you outline all these protocols in your book, right? So what I do in ending chronic illness, a lot of people, I did it like a cookbook in the chapter under the three B's. I do this literally week by week. These are the medications. These These are the lab tests you need to do. This is when you need an electrocardiogram to make sure your QT interval is good. It is written out literally like a cookbook that anyone can take ending chronic illness to their doctor, and they can just do it step by step so they know exactly the protocol. And I even put in here a low-dose Dapsone protocol for people that are sensitive, because many people get Herxheimer reactions where you're killing off the bacteria.

43:32The inflammatory response is huge. I told people how to do it much lower and slower for those people who, and as an example, on my wife when we didn't know the dosage. We gave her Dapsone 50 milligrams for a year, repeated her test, PCR positive in the blood. I gave her 100 of Dapsone for six months, relapsed within a month or two. A patient came in, by the way, this is how I discovered the dose. A patient came in who was sick for seven years, came in, he was third month, fourth month on Dapsone. He comes in and says, Doc, I'm feeling terrible. I said, oh, what are you taking? Well, I'm taking, you know, Doxy twice a day, Rifampin twice a day, and Dapsone twice a day.

44:08I said, oh my God, you're taking too much. You're taking 100 twice a day. I said, stop it. Come back in a month. He's been sick for seven years. He comes back in a month and goes, doc, I feel great. I have no symptoms. I went, what? I said, stop, don't take anything else. Just come back in three months. Comes back in three months, no symptoms. Comes back in six. So I said to my wife, would you like to be a medical guinea pig? This guy took a double dose of Dapsone, 100 twice a day for one month, and he doesn't have symptoms. And he felt sick because of the side effects of it. He was herxing badly when he did it.

44:37my wife did it for one month she's eight years in remission i had to figure out it's not long-term antibiotics it would it took me years to figure out the dose and how to combine the medications in a way that it was a very short-term effective protocol and my wife was one of the first people

44:52Dr. Mark Hyman:actually who got better from it that's quite amazing that's quite amazing most of us are walking around in a state of chronic stimulation your cortisol is elevated your nervous system is stuck in go mode and we wonder why we can't sleep or focus and one thing i've been using that i generally look forward to at the end of the day is the infrared pmf wrap from bone charge pmf otherwise known as post electromagnetic field therapy delivers gentle electromagnetic frequencies into the body that mimic what you naturally absorb spending time on the earth combined with red and near infrared light it's one of the few recovery tools that works while you're absolutely doing nothing i throw it on for 30 minutes on reading or winding down and i notice i sleep better on the nights I use it.

45:35It's lightweight, it's low EMF, it's free shipping, HSA and FSA

45:39Dr. Mark Hyman:eligible. And honestly, one of the simplest things I've added to my eating routine. So head to bonecharge.com slash hymen and use the code hymen for 15 % off. That's B-O-N-C-H-A-R-G-E.com slash hymen and you'll get 15 % off. I often say that food is medicine, but there's another part of the conversation we don't talk about enough. How we prepare our food matters too. The warmer months are actually a great time to reset your habits people are cooking more with fresh meals they're grilling they're eating lighter focusing on feeling better day to day and one small but meaningful upgrade is paying attention to the cookware used regularly i've been impressed with maiden stainless clad collection because it's designed without chemical coatings and built for durability for heat control and for everyday cooking their five ply stainless steel heats evenly handles high temperatures beautifully and is trusted by professional chefs in some of the best restaurants in the world.

46:29Dr. Mark Hyman:But what I like most is that it makes cooking real food at home easier and more enjoyable, which is one of the foundations of long-term health. If you're looking to upgrade your cookware, go to maidenware.com and use the code HYMAN-5 for 10 % off your first order. Again, I've been following you for a long time and tracking all the different iterations of your thinking. And this is definitely an evolution and it seems more elegant and it answers a lot of the questions that I have around these long-term antibiotic patients who just don't get better. I do not too long. I don't believe long-term antibiotics should be given to anyone because you know the effect of the microbiome on the gut and it doesn't kill the Lyme.

47:04It's suppressing the bacteria, right? By the way, they've even shown in some of these, you get more biofilm formation if you do this. So we need an entirely new approach, which is pulsing short-term while supporting the microbiome and then using these biofilm persister drugs like dapsone. And I do believe, by the way, even in Alzheimer's because dapsone inhibits this pathway in the brain NLRP3 inflammasomes. I don't know why anyone has not taken Dapsone like they did in the study from South Korea. 4 ,000 people, their Alzheimer's rates were like this. Use low-dose Dapsone.

47:36Dr. Mark Hyman:And they used it for what there? They were using for leprosy. But they found when they looked at the Alzheimer's cases, Dapsone was stopping people from getting Alzheimer's disease. And it's 4 ,000 people over 15 years that they looked at this. That's incredible. Wow. So let's kind of back up. We talked about all these six principal causes, the rivers of inflammation, creating an ocean inflammation, right? The infections, the toxins, the microbiome, leaky gut, food sensitivities, vitamin, mineral deficiencies, and sleep. And then you talk about the 10 downstream secondary effects. And this is really when you have all these insults and you don't have enough of the right inputs, there's a cascading effect of dysfunction throughout the body that echoes.

48:12Dr. Mark Hyman:And it's all the systems of the body. It's basically a network. And all the different ones are connected. Hormones, gut, immune, mitochondria, detox, they're all kind connected. And so this is how we think about things in functional medicine, but it's, you came to this through a different pathway and ended up in the same place. And I'd love you to sort of unpack the sort of the things that tend to go wrong because you can treat those directly, but if you don't treat the root causes, the six rivers, those things are, you might be able to move the needle a little bit, but they're going to kind of not really get better.

48:42Sure. I mean, and as an example, so one of the 10 downstream effects is mitochondrial dysfunction. If you have ongoing inflammation in your body, the mitochondria have nothing to protect them against all this free radical oxidative stress, right? It's not like the DNA that has histones surrounding it. So that's why we do a mitochondrial regeneration protocol after we do these treatments. But if you're somebody taking ATP 360 and CoQ10 and urolithin and A and, you know, MitoNR and other things I'm taking myself because I'm doing my own biohacking, it's not going to work. You may say, hey, I'm doing everything right.

49:12I'm exercising. I'm on a low-carb diet. I'm getting enough sleep. I'm doing mitochondrial. Why isn't it working? Well, you didn't get to the first root causes of where the inflammation's coming from, right? But also in this inflammation, it affects your hormones because the inflammation is affecting the hypothalamic pituitary axis. So men come in with low testosterone in their 20s with 100 to 200 testosterone, and they're getting beta-HCG shots, and they're getting testosterone. And it's like, hold on. It's the Lyme that's causing your low testosterone, right? And the adrenals are shot. Close to 100 % of my patients have low adrenal function on a DHEA cortisol.

49:44And again, if you treat these six rivers of inflammation, but you don't treat the adrenals, they're not going to get better. I have a person. This guy was treating years ago. He was sick for about eight years. We found Lyme Babesia-Bart. We started looking for it, and we found low adrenals. And before I even had a chance to treat the Lyme, and this was going through his hospital records, his cortisols were really low. And I said, all right, I'm going to have to treat all this. But I said, let me give you some hydrocortisone for the, I mean, it was really low, literally Addisonian type low cortisone.

50:14He said, I don't want to do it. They gave me prednisone in the hospital. I never want to take steroids. I gave him an adrenal glandular. Now this guy had multiple M-sids factors making him sick. Lyme, Babesia, the rest. Within a week of taking an adrenal glandular, he said, doc, I'm eating 90 % better. So personalized precision medicine, you know, this the way I do, even if you have eight or nine M-sids factors on your list, it might be one factor that's keeping you ill. And in a lot of the patients, it's adrenal. We do the mitochondrial, but you got to definitely get the hormones balanced. But the other downstream effects is immune dysfunction.

50:47Many doctors don't check immunoglobulins, subclasses. They don't check natural killer cells. They don't do CD4, CD8. Well, if this is in, you know, how do you check your immune system? Or they have autoimmune disease. People don't really realize that you can actually test your immune system. Right. So, and same thing, we check the autoimmune markers, one of the downstream effects, where you get neurological issues with brain fog and you're going from doctor to doctor and understanding why your memory's off, right? And you've got amyloid and P-TAL now, maybe from other sources, right? Or psychological factors, trauma, where you need the limbic retraining.

51:17And then you're deconditioned, right? And a lot of people also, and you know this, have fatty liver. One third of the world's population has non-alcoholic stayout of hepatitis or fatty liver. Now they call it metabolic. Metabolic. Right. And it changed the name. Just like PCOS is now PMOS, right? It was the same thing. But it causes insulin spikes with metabolic syndrome. And it's a silent factor for cirrhosis and for liver cancer. And you could go to a doctor with normal lab tests, your liver functions are normal, but you're overweight. The doctor doesn't check an ultrasound and there's the fatty liver.

51:48We were finding it. So these 10 downstream effects is, again, the liver, the immune system, autoimmune, mitochondrial, hormonal dysfunction, deconditioning, neurological issues, psychological issues, and POTS disordomia. People come in with long COVID to my practice, right? They're tired. They've tried everything. Nobody did sitting and standing blood pressure and pulse rates to find out if they had POTS disorder. Yeah, yeah. And so POTS disorder is not treated with antibiotics, right? It's salt fluids. It's midadrine. It's vagal retraining. It's limbic retraining. It's getting what causes too.

52:17Because it causes fatigue, brain fog, anxiety, palpitations, right? POTS disorder has a lot of the same symptoms as Lyme and Bartonella and mold. So that's why a differential diagnosis is so important in these patients. And disorder shows up in 40 to 50 % of our patients at this point.

52:34Dr. Mark Hyman:I'm going to push back a little bit on the differential diagnosis because in medical speak, that's what doctors do is they try to winnow down what your story is to one single diagnosis. But you're really talking about a true differential diagnosis, which is thinking through past the diagnosis. Okay, what is actually the root cause? What are the systems that are out of balance? How do I treat all those six causes and 10 downstream factors? And you come upon the same framework that I have, which is that you have to deal with the root causes, but you have to also deal with the train wreck that happened as a result of those root causes.

53:04Dr. Mark Hyman:which is adrenal dysfunction or hormonal dysfunction or gut issues, you have to kind of clean up the mess. It's like, yeah, you have to put the, if the train's off the tracks, you got to fix the tracks, but then the train also went off the tracks and created damage everywhere. So you got to clean that up. And, but if you, if you did the cleanup first and you don't deal with the root causes, people tend not to get better. That's the kind of trick that people go. Oh, and a lot of people out there are doing this or they're giving hormones or they're giving, you know, gut stuff or they're giving different treatments, but they're not actually getting to the things that matter, like the mole, the tick.

53:34I was surprised that when men come in in their 20s and 30s with low T and their testosterone is off, for some reason, a lot of the doctors didn't know that Lyme and Barton-Elnesings, because of inflammation in the brain, cause low testosterone. And I will give them a little bit of Clomid, Clomafen, 25 milligrams, two or three times a week with a Remed-X to stop aromatization. And I'll get their testosterone from 100 to 600 without beta-HCG, without shots, resetting the hypothalamic pituitary system, getting the hormones back and balance. So, you know, I have all of these tricks in the H's for hormone chapter, you know, in any chronic illness, because if you're a man and you want to have kids growing older, you can't be getting these shot.

54:09These testosterone shots are shrinking your testicles by 15%, stopping your own hormone production. So yes, it's, it's always about the root causes, but I find that, you know, even the functional medicine community, you see a complex patient that you're with them for hours. The beauty of the 16 point M's, it's a checklist, right? It's just make sure you've just gone through these things just to make sure you're not missing anything. And I find, you know, you can get caught up, you know, in these, in these very complex patients where you might forget to check the mold or do the adrenals or because the patients are, you know, you're the first doctor really listening to them and taking the time to listen to them.

54:41Dr. Mark Hyman:You're right. I mean, it is, it is a checklist and I, and I do go through that mental checklist, you know, and I, I often have the, uh, the echo of Sid Baker, who's my mentor in my head. He says, you know, have you done everything you can for this patient? Which means what haven't I thought of? Like, what am I missing? Like, not what did I find, but actually what, what am I missing. And when you go hunting, you find stuff. And it may be the thing or may not be the thing, but you have to actually go hunting. And I think most doctors don't know how to hunt. They don't know how to hunt for the root cause.

55:08Dr. Mark Hyman:They don't know how to test for mold. They don't know how to test for metals. They don't know how to test for ticks. They don't know how to test for the gut microbiome. They don't know how to test for leaky gut, for food sensitivity. They don't know how to test for hormonal dysregulation. The whole gamut of things that you and I deal with every single day with our patients, and that gets these people who are literally incurable cured. It's not rocket science. It's just good science. But you know, you've got to teach doctors. I had a mentor just like you did with Sid Baker. My mentor was Dr. Rosenek.

55:35He was the most brilliant internist I ever met in medical school. He's the one who influenced me like Sid Baker did for you. And what he taught me is also to keep getting underneath to the root causes. But you know, what I did in Ending Chronic Illness regarding that is I have, starting around page 30, if you have symptoms, like let's say you have neuropathy and you've been to all these doctors, you're on Lyrica and you're on Gabapentem and you're on Elevil, you still have neuropathy. Maybe somebody's not checked you for Lyme and Bartonella and mold and heavy metal toxins that cause neuropathy.

56:03And what I find is, and I did this in the book, I list the disease, right, the lab testing for it, right, and how you do the differential diagnosis so that people can actually work with their healthcare providers so they don't miss anything at this point. And the Horowitz-Emsitz questionnaire, which is on my website, cangetbetter.com, If you take this questionnaire, it will give you a probability of tick-borne, but also you bring it to your doctor. There's 38 items on there. You might forget to tell your doctor you have drenching night sweats intermittently, which was the Babesia, the parasite hiding in the background.

56:33So the beauty of the questionnaire is we validated it in 1 ,600 people. It's an easy questionnaire to bring to your doctor. So nothing is missed, right? And so that's why -

56:43Dr. Mark Hyman:It's available in the book and online too. The questionnaire is in the book as well as these different, it's online also under cangetbetter.com. You can just download the questionnaire. Cangetbetter.com. Cangetbetter.com. Yeah. And, you know, Pete, you've been referring to EMSS. What it stands for is Multiple Systemic Infectious Disease Syndrome. Just to ask about that, what if it's not always infectious? Like what if it's just mold or heavy metal? It may not be lime, right? How do you have the I in there? The way I'd now look at chronic illnesses after finding that these 16 factors are underlying literally autism, Alzheimer's, chronic fatigue, is you don't have to have Lyme making you ill.

57:19Absolutely not. But it could be, for example, chronic fatigue syndrome, MSIDS, meaning you don't have Lyme that's causing it, but you may have Bartonella. You may have mold. I was surprised when I did the research on this book. Fibromyalgia, I didn't learn in medical school that mold toxins are showing up in 70 to 80 % of fibromyalgia patients. They're getting drugs from their doctors for the pain without understanding that the mold was driving the inflammation. I didn't know this, by the way, until I did my own research for the book. So these diseases for me are now kind of like Alzheimer's, MCIDS, chronic fatigue, meaning absolutely you may not have Lyme.

57:53You may not have Bartonella, but you could have mold and heavy metals. You could have microbiome disruption, adrenal disruption. The point being, you just go through the root causes. And it's just a simple way of making sure that nothing is being missed. Because both you and I have seen the miraculous results in getting people better with this type of protocol.

58:08Dr. Mark Hyman:So we kind of dove into a little bit about the protocol for treating these infections, which is just for people listening, it's not what your traditional doctor will be doing or offering you, I promise. But it probably is what you should be doing. And the book, Ending Chronic Illness, is a great resource for that. Metals, we talked about chelation. That's a little more straightforward. Fixing the gut. I've done a lot of podcasts about that. That's not that hard. I mean, it's a process and it requires the five-hour program we talked about in functional medicine, which is to rebuild your gut. The mold thing is a bit of a can of worms.

58:39Dr. Mark Hyman:So I want to kind of double click on the mold thing because you keep mentioning it and it is a persistent thing. And then there's 50 % of buildings are water damaged. In fact, I'm in my house now. Every year I have a guy come and inspect just because I got so sick from mold and almost died from it. And I'm paranoid about it. That's why every year I have it checked and anything wrong, I fix immediately. But I don't know if you know this either, but about 10 years ago, I had a series of things happen where I lived in an old barn in New England, not too far from where you have a place in Hudson Valley.

59:10Dr. Mark Hyman:It was an 18, I think 98 barn. So it was like 125 years old, you know? And there was mold in the basement. And I thought, I didn't realize that one of the windows had opened and leaked in. It kind of cut about it. I didn't really smell it. but I started having this cough and I, and I was, you know, running around, writing books, giving talks, trying to change the world, the usual stuff. And I was like coughing. I'm like, ah, it's going to go away. Yeah, it's going to go away. And it didn't go away for a year. And then I was like, I think it's probably my house. So like I had to check my house, checking was terrible.

59:43Dr. Mark Hyman:So I had moved out of my house or renovated my house. And that was the whole project. And then I, I took an antibiotic for a dental and like a root canal that was infected and I had the tooth pulled, but I took clindamycin and then I fell and broke my arm riding a horse in New Zealand. It was like, boom, boom, boom, boom. And I saw the lung doctor at Cleveland Clinic and I got prednisone for 10 days, which basically cured my cough, which was great. But then I just, my whole system collapsed and I got colitis. I got C. diff. uh i ended up just having this sort of cascading inflammatory problem and my whole gut was inflamed from basically my stomach all the way to my butt and i developed ulcer of colitis i was in bed i lost 30 pounds the mold was just devastating me and i even though i kind of cleaned up the mold i was i was still my system was in total breakdown and i thought i was going to die i literally thought i was going to die i couldn't work my months moldiness is a lot more serious than people realizing.

1:00:45Yeah, it's so bad.

1:00:46Dr. Mark Hyman:Like, and it just, there was a cascading effect in my case, but I want people to understand this is a real thing. And by the way, you can't just pick it up on doing a stachybotrys titer through, you know, Questra Lab. No, no. So we mainly use real-time labs. Neil Nathan has been one of my mentors on this with Jill Krista. And they're mentioned, by the way, in the book. But I use real-time labs from doing glutathione, getting people in saunas to mobilize the toxins and finding that up to 90 % of my patients are showing up with aflatoxins, gliotoxins tricolacines i mean they're showing mine were just so high yeah and the problem is is that they're mitochondrial poisons and they you know they're affecting your immune system and they cause fatigue brain fog um pain neuropathy they cause all the symptoms you see with lyme disease right so i didn't initially i was battling with neil going come on neil it's mostly tick boy and then i realized over time no no it's a combination of facts so you know so we did real time labs and and i found a protocol and i have it in there i think it's under the l is for lifestyle chapter with an oral protocol, because I want people to be able to use things that are generic oral that anyone can get.

1:01:46So we're using oral, you know, phosphatidylcholine. I'm using one from with a molecular or zymogens, phospholine four to one. We're using BioPC Pro. We're using a whole host and even GI detox from biobotanical research with bentonite clay and charcoal. And so I created a protocol and the protocol is written out also like a textbook, you know, a cookbook in the book where people understand exactly when you take these supplements with NAC, alpha lipoic acid, glutathione, phospholidylcholine, when you take your GI detox, you know, how you do this. And we do get rid of the vast majority of these malt toxins doing oral protocols.

1:02:23Now, some people would do IV phospholidylcholine, particular cane protocols. My goal in doing this book was something that was accessible for the average person, just oral generic that anyone could do. And so that's why I wrote it out this way.

1:02:35Dr. Mark Hyman:Yeah, I think the orals can work quite well. Well, I found, you know, for myself, what rescued me was getting ozone therapy and hyperbaric oxygen together. It sounds like a crazy treatment, but I was desperate and I did it. And I was better within a couple of days, starting to kind of recover. I also, I also did the intravenous phosphatidylcholine protocol, which I think is one of the most effective things that personally I've ever done to resuscitate my own mitochondria and get rid of toxins. and it gets rid of not just the mold, but it gets rid of a lot of cellular toxins and it reboots your cell membranes and your mitochondria.

1:03:11Dr. Mark Hyman:You can do it orally. Some people have a little trouble tolerating the high doses of phospholcholine because it kind of makes you have diarrhea sometimes. But it's actually important to recognize that this is a real thing, that it has medical treatment, even though your traditional doctors are not hearing about it or knowing about it. The testing, you know, I want to kind of dive a little bit more on that. You talked about this real-time lab, which measures urine mycotoxins. And I've heard some controversy that that might actually pick up, you know, food mycotoxins that aren't actually. It's possible.

1:03:43There are food mycotites. About 25 % are probably coming from foods also. Yeah.

1:03:46Dr. Mark Hyman:So it may not just be what's in your system, but these are low molecular weight circulating mycotoxins or toxins that come from the mold. They're getting recirculated over and over. Even if you've removed yourself from the mold environment, they stay persistent in your system and you have to get rid of them. So that's kind of what the binders and other things you're talking about. Exactly. Yeah. What about the other lab tests do you use for assessing this? like the SIRS, the whole concept of chronic inflammatory response syndrome. It's almost like you're kind of MSID syndrome, but it's really, these are like a mold.

1:04:13Dr. Mark Hyman:And there's specific lab tests. Do you find those helpful? Like the C4A, TGF beta-1, MSH, MMP9? What I did again, I have a specific chapter on inflammation and how to use these biomarkers. And I did it as like a three-level biomarker. Like the first level might be do a CRP, do a SED rate, do a C4A, look at VGF, vestral endothelial growth factor. So like there's a first set, I have 10 biomarkers I start with. The next level I do, for example, looking at functional medicine labs, like what's your free radical oxidative stress with lipid peroxides, 8-hydroxyiguinin for DNA damage, protein carbonols, T-bars.

1:04:47And the third level, which I think people now need to get, is get your Alzheimer's biomarkers done. And these are from Quest. Like you can get a P-Tau 181, P-Tau 217, neurofilament light, and beta amyloid 4240 ratio from Quest laboratories, and it is completely covered. Yeah, we do that. We do that with Function Health.

1:05:05Dr. Mark Hyman:We now, yeah, we have all the whole brain biomarkers on Function Health and it's amazing. We're seeing people using them and then able to reverse. I mean, I was shocked that 50 % of my patients were showing up with these Alzheimer's biomarkers, right? And I just thought, oh, it's Lyme and BART causing it. And then I, as I said earlier, it's like, Hulk, if you went to a neurologist with this, you're going to be treated for Alzheimer's without finding out where the inflammation was coming from. So yeah, so I listed out these level biomarkers, which you've been doing actually for, of course, for years.

1:05:30You know, but the problem is they're not all specific in certain areas, right? I mean, VEGF we see with long COVID, but we see it with Bartonella. You'll see with cancer. You just have to know. Yeah, the not specific. You have to know how to interpret it.

1:05:41Dr. Mark Hyman:It's like the pattern that they form. Correct. I think we're looking for patterns because any one biomarker is not going to tell you the whole story. Right. Like somebody might have Lyme joint pain and their MMP9 is high. The matrix metal protein is high. It's like, okay, that confirms that the Lyme is affecting your joints, right? You always have to clinically kind of put it together. When I first kind of got the aha about mold was probably close to 30 years ago. I had a patient and her daughter who came to see me. And the mother had chronic fatigue and the daughter had juvenile rheumatoid arthritis.

1:06:07Dr. Mark Hyman:And they were sleeping in separate bedrooms. And I kind of took a history and I got that there was some mold issue. And I started digging around. Turned out that I had their house checked and they had different molds in each of the rooms. They were different. And then I did the lab test, which is not available anymore. It was, it was, uh, immunosciences, which is, I remember it. I remember it well. And on that lab test, he, you could measure mycotoxin antibodies. So not just antibodies to the mold, which you could get, but also to the antibodies, to the mycotoxins. And I, and I could see which molds they had in each, each, the mother and the daughter, and they were different and they matched the molds that were in their room.

1:06:53Dr. Mark Hyman:And because of this lab test and what we found with them, there was a lawsuit where they got to recover, you know, to get their house redone for the insurance. Insurance companies did not like this. And the - No, in general, the insurance companies do not like a lot of the things we do as functional medicine. Well, I mean, the insurance companies have paid for the house to be rebuilt. And so that apparently, I don't know if it's true or not, I heard rumor that the lab was shut down by the sort of authorities in California because it was a California lab because of some of the pressure from the insurance companies.

1:07:23Well, right now, I mean, there are labs like Vibrant Laboratories and Great Plains. I mean, there are other ones that now do some of these antibodies, but you're right. That was a very comprehensive protocol.

1:07:30Dr. Mark Hyman:Yeah, and I was like, wow. And now it's important to look because when you start looking, you'll find stuff. And I think that the sad thing is insurance often doesn't cover things for these patients. And sometimes the labs you're talking about are covered by traditional insurance, sometimes they're not. And I think, you know, people, it's unfortunate. I don't know if you're aware of this, but you might even want to apply for this. But there's a grant that was established through the HHS Innovation Department and Medicare, Center for Medicare and Medicaid Innovation for$100 million to study functional and lifestyle medicine for chronic illness.

1:08:04Oh, I didn't know about this.

1:08:05Dr. Mark Hyman:Yeah. So there's a big pot of money. They're looking for centers to study. So if you're... See, what I would like to do is take the 16-point M-sids model and look at autism, ADHD, Alzheimer's disease, chronic fatigue syndrome, fibromyalgia, chronic Lyme disease, long COVID. Look at all of these diseases that are making people tired and achy with brain fog. We already know they're associated, the 16 points, but how much is the causality, right? So just like I now reverse the Alzheimer's biomarker for the first time, but we need a randomized multi-center trial, I'd love to see that$100 million used that you take all of these major diseases affecting Americans.

1:08:38It'd be a great study. Yeah. I mean, look, 60 % of Americans have one chronic illness. 25 % have two or more. 86 % of our healthcare costs and 70 % is chronic disease. And our GDP is about to go to 20%.

1:08:49Dr. Mark Hyman:And that's why Medicare is starting to go, wait a minute, we're not getting this right. No, it's got to be root cause medicine is the only way this is going to be fixing what's going on right now. It's not what they're teaching in medical school of name the disease, show the drugs out of it. You've got to get to the underlying inflammatory factors. It's true. My daughter just graduated medical school and she went into orthopedic surgery because I'm not going to. Oh, congratulations. Because, you know, regular medicine is kind of screwed. This book should really be a textbook for doctors, honestly.

1:09:15Dr. Mark Hyman:I mean, it really should be. And I think, you know, for anybody who's struggling with chronic illness, who's hitting a dead end, who's gone to 30 doctors or 20 doctors or five doctors or a hundred doctors, there are answers. And I think that's what drives you and I, I mean, we're probably, what, you're in your 60s now? I'm 70. I just turned 70. Okay. Congratulations. I'm catching up soon. I'm going to be 67 this year. And, you know, we're still going at it because we just see the desperation out there in people. And we so feel the suffering. I mean, the most rewarding thing you can do, which I think you know at this point, is getting these chronically ill patients better that have been to so many doctors.

1:09:49It's like, what gives you greater joy than getting these patients better who've been through, you know, the mill for years and years and years without answers? And I really learned this over time. the thing that gives me the greatest joy, it's always getting a chronically ill patient better. And that's why I wrote this book, is I needed to get this information out for people so people would have it.

1:10:07Dr. Mark Hyman:I'm working on a book now, which is similar. It's not called Ending Chronic Illness, but it's called How to Live 100 Other Years, essentially, which is a similar idea. But it's like, here's how the body actually works. What your book really puts out there is this thesis that the map we had, that the constructs we developed in medical school to diagnose people according to specialties and diseases is really outdated and that it's helpful to a point, but it doesn't really help you navigate this chronic landscape. I mean, this landscape of chronic disease. It doesn't help you navigate these patients who come in, who've struggled with big symptoms that people often dismiss or the doctors dismiss or the relatives dismiss as, you know, they're just in all their head or this kind of way we kind of dismiss stuff that we don't understand.

1:10:51Dr. Mark Hyman:There is, there is a map and, and I, and I'm so grateful that you took the time. and this is a very long book. I don't know. It's 640 pages with over 2 ,000 scientific references. But the references are not even in there. The references are, no, in fact, the references are on my website, cangetbetter.com. If you want to see the references, go on cangetbetter.com and look on the bottom. You'll see the references. I got the same problem. My book's like 800 pages and I'm like, and like I've got thousands of references and I have to put them on the website otherwise the book will be even 100 pages longer.

1:11:17Dr. Mark Hyman:I think you and I are part of a group, a larger group of physicians who recognize that the way we think about chronic diseases is just flawed. And that there's actually an emerging framework of systems thinking, of root cause thinking, of looking at personalized healthcare, personalized medicine. No two people have the same disease. No people have the same causes. No two people have the same treatments. It's very personalized. And that requires a level of focus and understanding that most doctors just don't know how to do. And the framework you have is really powerful. And it's essentially what I do.

1:11:49Dr. Mark Hyman:I don't actually have the same labels. It's overlapping almost entirely. because it's just the body. But I think I have to wonder, you know, in terms of where you're going next with all this in terms of the Alzheimer's work. Because that paper you published, I want to sort of dive into a little bit, you know, just to help people understand. You know, you had a patient who had Alzheimer's, who had elevated biomarkers of Alzheimer's, and who also had tick infections. And then you treated the tick infections, and their symptoms got better. Alzheimer's biomarkers reversed. Biomarkers got better. And it's the first time in the world it's ever been done.

1:12:20I didn't realize that, by the way, when I published the paper. It's in the Journal of Alzheimer's Disease Reports, it's April 2026, so anyone can read it. But what astonished me is this P-Tau-217, which most neurologists consider to be the most sensitive and specific biomarker for Alzheimer's. I reversed it completely to normal by 63 % in nine weeks with an oral antibiotic regimen. But here's the beauty is Dapsone combination therapy, the number one effect it always had was improving people's memory, statistically, in these 375 patients. But what I didn't have years ago, we couldn't get these Alzheimer's biomarkers.

1:12:52They didn't exist. Now that I started testing people, it's like, oh my God, I possibly could reverse some of it. So that this is kind of big news.

1:12:59Dr. Mark Hyman:It's big news. It's almost like measuring a blood sugar for diabetes. You can see if it goes up, you can see if it goes down, it can be reversed, it can get worse, depending on what you're doing. And also that Alzheimer's is not just, you know, an end stage. There are 16 factors underlying it. And I proved the amyloid P-tau infection hypothesis that everyone's been talking for years, like chlamydia and pneumonia can cause it, viruses can cause it, but none of the studies they've done, ever made a difference. That's what the Cochrane report was saying. So this is really the first study that gives people a glimmer of hope to say, if you were diagnosed with Alzheimer's, go through the model, right?

1:13:30Go through A is for, you know, ADHD, autism out, go through the book, go through these 16 points and work with your doctor. And then see if you do have any of these Lyme bands, like we talked about for Lyme or even Bartonella, you need to be treating this because it may do it. Now, again, we need a randomized multi-center control trial.

1:13:47Dr. Mark Hyman:The case study. This is one case study. I have a second case study. I recently did it also. In fact, I kept him in my practice longer because he had it and he was getting divorced and I felt bad for him. He was with me for like 30 years. And I said, all right, I'll do my best. And lo and behold, the amyloid ratio, it reversed after he finished the Dapsone protocol. Again, it's two case studies at this point, but it means this is where the money needs to go. Right now, we should be putting our research monies into this. That's the thing. You know, when you think about it, like, you know, we spend billions of dollars on the wrong thing.

1:14:16Dr. Mark Hyman:and even a few million in the right thing could make a massive difference. But the problem is, like you said, these drugs are off-label. They're not necessarily making people money because they're all generic. Well, that's why I'm giving them to people so that they are generic and people can afford them. But yes. But the drug companies aren't putting millions of dollars into these research studies because the government has to do it. Right, but the top people in our government should really be looking at this because if almost 20 % of our GDP is chronic disease healthcare costs, we're going to break the bank in this country if we don't do something about it, apart from all the suffering from people who have these chronic illnesses.

1:14:50Dr. Mark Hyman:And I love that you came at this in a similar way that I did through the Buddhist lens of understanding that being in service to people and helping relieve suffering and compassion is a good way to live your life, you know? You know, I like to think of myself as a good person, that I would have done this. But the truth is, is I really do think my Tibetan teachers had a huge influence on, that I wouldn't give up. Like I kept putting myself in people's shoes going, oh, you're not better. What else is it? What can I, like, I just would not give up. stubborn like me. And 42 years later, it's like, all right, I've got these 13 ,000 people.

1:15:21We got better, right? We're explaining it. Yeah. So it's, I think that motivation of, you know, loving kindness, compassion, and just not giving up, always trying to get people better. If you have to have this as a physician, if you don't have this, you're just not going to go the full, you know, the full length.

1:15:35Dr. Mark Hyman:And you also forsake yourself. So you understand it. That's the thing. Yeah. You know, not that we wish all doctors get sick so they can be better doctors, but it does And my wife, my beloved, you know, had all 16 factors made her ill, and she's now eight years without one symptom. That's amazing. That's amazing. Wow. Well, thank you for writing this book. Thank you for the decades of persistent hard work, being a medical detective, figuring all the puzzles out of the body and helping people understand what they can do to actually get better. Now, the beauty of this, this should give people hope that if you're someone suffering from chronic fatigue or aches and pains and neuropathy, brain fog, memory concentration, mood disorders, there is hope for you.

1:16:11It's not like you just have to take drugs for the rest of your life or live with it. I basically broke down how you do the differential, how you look at the disease, right? What are the lab tests you need to do? What are the potential? And it's what I've done over 42 years to get people better. And every story, by the way, in ending chronic illness are personal patients I have treated with autism, with, you know, Alzheimer's, whatever it was. These are personal patients I've treated myself.

1:16:33Dr. Mark Hyman:That's true. It's quite a career you've had. And people want to learn more, they can go to cangetbetter.com. cangetbetter.com and my medical detective substacks that are free to sign up. Every week I do one. I did one today on heat stress and heat strokes because of the heat wave, the heat dome. people, you know, don't realize, like, if you have cardiovascular risks and you're taking xylitol in your diet, which has now been linked, right, to strokes, right, that, and now you have heat stress, that you are more at risk for certain strokes than you might have been from the past. So I actually did a substack today on it, just because of what's going on now in our country with heat.

1:17:07But yeah, so the medical detective substack, cangetbetter.com. I have Facebook, Dr. Period, Richard Horowitz. People can follow me. And lots of books, lots of books. Lots of books.

1:17:15Dr. Mark Hyman:Ending Chronic Illness is the new one. It's great. everybody should get a copy. It's out now. And I'm, thank God I got my copy. I definitely have thought of you over the years as one of my mentors. And it's so great to have you here on the podcast. Mark, it's so great to see you again. It's been too long. Yeah. If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to The Dr. Hyman Show wherever you get your podcasts.

1:17:48Dr. Mark Hyman:And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on The Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health, where I am Chief Medical Officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional.

1:18:19Dr. Mark Hyman:This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at ultrawellnesscenter.com and request to become a patient. It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public.

1:18:51Dr. Mark Hyman:So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.