Rational Wellness Podcast 050: Lyme Disease with Dr. Darin Ingels

Dr. Darin Ingels talks about how to manage patients with Lyme Disease with Dr. Ben Weitz. 

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Podcast Highlights

3:15 Dr. Ingels explains that he got interested in Lyme Disease because he suffered with it and found that antibiotics were not the long term solution. He realized that taking herbs and changing his lifestyle were better long term strategies for treating Lyme Disease. 

5:25  We discussed the symptoms that might alert you to the fact that a patient has chronic Lyme Disease. Dr. Ingels pointed out that it can be confusing to diagnose Lyme, which is why it’s known as the great imitator. Patients may complain of brain fog, memory problems, dizziness, and balance problems.  There can be migrating joint point, numbness and tingling, and a sensation that there are ants crawling under their skin, or a burning sensation in the skin.  There can also be chronic swollen glands, fevers, and chills.

7:30  Dr. Ingels points out that Lyme is often associated with chronic rheumatological conditions like rheumatoid arthritis and lupus. Lyme can also be a trigger or catalyst for things like Multiple Sclerosis, Parkinson’s, and Alzheimers. Dr. Ingels explained that if you treat the Lyme their MS may get better or go away. He explained how when the immune system attacks an infection like Lyme Disease, through molecular mimicry it may then attack our own tissues and this can result in triggering an autoimmune diseases like MS.

10:40  I asked what is the best way to test for Lyme Disease?  Dr. Ingels said that the conventional testing is not very sensitive–say 40%–and the diagnosis a lot of times is based on clinical symptoms.  The testing is less accurate the further away you are from the initial infection.  He said that the testing offered by Quest and Lab Corp is not very accurate but testing offered by specialty labs like IGenx are somewhat better. 

15:32  Dr. Ingels recommended also testing for common Lyme Coinfections, like Bartonella, Babesia, Anaplasma, Ehrlichia, Tularemia, and a new virus called the Powassan virus, which has been responsible for a few recent deaths.  These are infections that are also spread by ticks.

18:03  Dr. Ingels described his 5 step plan for treating Lyme Disease: 1. Treat the gut, 2. Alkaline diet, 3. Herbal protocols, including the Zhang protocol and the Cowden protocol,  4. Clean up the toxins from your environment, like mold, 5. Lifestyle factors like sleep and exercise. 

28:34  I asked Dr. Ingels about using Ozone therapy, a commonly used modality among Lyme practitioners I know, and he said that the benefits of oxidative therapies like ozone and hyperbaric oxygen are short term and they are also expensive, esp. since you have to do quite a bit of it.  Dr. Ingels likes to use Low Dose Immunotherapy (LDI), which he finds very effective.

34:05  Dr. Ingels explains how you repeat his 5 step protocol again for patients who are still symptomatic.

 

 



Dr. Darin Ingels is a Doctor of Naturopathic Medicine practicing in both Southern California and also in Connecticut, who has a specialty in treating patients with chronic Lyme Disease and he has recently written The Lyme Solution: A 5-part Plan to Fight the Inflammatory Auto-immune Response and Beat Lyme Disease, which can be found on Barnes and Noble, https://www.barnesandnoble.com/w/the-lyme-solution-darin-ingels/1126791520   Dr. Ingels can be reached at https://dariningelsnd.com/ or you can call his office in Irvine at 203-254-9957.

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure as well as chiropractic work by calling his Santa Monica office 310-395-3111.


 

Podcast Transcripts

Dr. Weitz:            This is Dr. Ben Weitz with the Rational Wellness podcast, bringing you the cutting edge information on health and nutrition from the latest scientific research, and by interviewing the top experts in the field. Please subscribe to the Rational Wellness podcast on iTunes and YouTube, and sign up for my free e-book on my website, by going to drweitz.com.

                            Let’s get started on your road to better health. Hey, Rational Wellness podcasters thank you so much for joining me again today. For those of you who enjoy this podcast, please give us a review on iTunes, it helps more people find out about the Rational Wellness podcast.

                           Our topic for today is Lyme disease, and we’re here with Dr. Darin Ingels. Let me tell you a little bit about Lyme disease first. So, Lyme disease is actually a very complicated and confusing disease that starts originally with an acute infection that can become chronic, and that goes on for years. Unfortunately a lot of people are not even aware that they have the initial acute infection, and this Lyme disease actually starts with a tic bite. Of course the tics can be so tiny that they’re very hard to see. And this results in an infection, with a corkscrew like bacteria, known as Borrelia Burgdorferi, although now we know that there are a number of different strains, including Borrelia, Miyamotoi, which is found more commonly on the West Coast, and a bunch of other strains found in other parts of the country and in other parts of the world.

                         After the initial infection, Lyme may create a chronic condition that’s very difficult to detect and treat. Such patients may not have any knowledge about having been bitten by a deer tic, and exposure could’ve been years ago. The Centers for Disease Control estimates that there are approximately 300,000 new cases of Lyme disease per year in the US, and this number seems to be increasing.

                         I’m happy that we have Dr. Darin Ingels joining us today to explain how to deal with Lyme disease. Dr Ingels is a licensed naturopathic doctor in both the states of California and Connecticut. His practice focuses on environmental medicine, with an emphasis on Lyme disease, pediatric acute onset neuropsychiatric syndrome, known as PANDA’s, and chronic immune disfunction, including allergies and chronic infections. Dr Ingels has published a number of books, including the Natural Pharmacist, Lowering Cholesterol, Natural Treatments for High Cholesterol, and his book, The Lyme Solution, a five part plan to fight the inflammatory auto-immune response, and beat Lyme disease, which will have been just released by the time this podcast airs. 

                           Thank you Dr. Ingels for joining us today.

Dr. Ingels:            Good morning Ben, thank you for having me.

Dr. Weitz:            So, Darin, can you tell us how you became so interested in Lyme disease?

Dr. Ingels:            Sure, I became interested in it because I got it. There’s nothing like some personal experience to give you a very quick education on how to deal with it. So I actually contracted Lyme disease about 15 years ago, 3 weeks before I was set to open my own practice. I had classic Lyme disease with headache, joint pain, 105 fever, and a big bullseye rash on the back of my leg.  And I underwent conventional treatment with doxycycline, and after four days of treatment I actually felt quite well. But in retrospect, when I opened my practice, as you know I was the doctor, the receptionist, the bookkeeper, and I was doing everything. So it was 10, 12 hours days, and after about eight months of keeping up that schedule, I started to relapse and get symptoms again.  So I went back on treatment, and it wasn’t working, it changed treatments, it didn’t work.

Dr. Weitz:            So your initial treatments were antibiotics, right?

Dr. Ingels:            Yeah, my initial treatments were doxycycline, which is the recommended treatment for acute Lyme disease. And I did take it for 21 days, even though I felt better after about four. But after eight or nine months of keeping up with that schedule, and I started getting symptoms again, when I went back on the doxycycline or the antibiotics, it really didn’t do anything.

Dr. Ingels:            So I changed antibiotics and it still didn’t do anything, and over the course of really eight or nine months I kept changing antibiotic protocols, but it wasn’t helping, in fact I was getting a lot worse. So I had actually had a couple of patients that had seen a doctor in New York City, a Dr. Zhang, who’s a Chinese medical doctor, and licensed acupuncturist, and he had been treating people with Chinese herbs.

Dr. Ingels:            So I saw him, he treated me, and it really got me 85% better in the course of about three to four weeks after starting his therapy. So I realized that I had kind of set the stage with my own lifestyle, that by not really taking care of my self it had allowed this organism to persist and eventually start to creep up and cause problems again.

Dr. Weitz:            Interesting. So what are the symptoms that would make you first suspect that a patient may have chronic Lyme disease? Because, you know, the acute disease with the bullseye rash, that’s relatively easy to know what’s going on, but the chronic patients, which is really the bulk of the patients that we might see for Lyme disease, and which is really the biggest problem, how do you identify that?

Dr. Ingels:            You know it can be challenging. We call Lyme the great imitator or the great mimic. It looks like a lot of different things, in fact there are upwards of 100 different symptoms that are associated with Lyme disease. So my feeling is when you have a chronic illness, if you’ve ruled out everything else and you can’t figure it out, that might be worth investigating.  But one of the things that we typically see in the chronic Lyme is this sort of myriad of different neurological symptoms, and people will complain of brain fog, short term memory problems, dizziness, balance problems. We can still see a lot of the symptoms you might see in acute Lyme disease, so people will complain of migrating joint point where it kind of wanders from joint to joint. One day it’s your left knee, one day it’s your right elbow, next day it’s your right ankle. You can see what’s called neuropathy, numbness and tingling, typically in your hands and feet, but really can occur anywhere on your skin.

                           People also describe what we call a sensory distortion where they’ll feel like there’s ants crawling under their skin, or a burning sensation in the skin. And you look at the skin and it looks completely normal, that tends to be associated with Lyme. You can also get chronic swollen glands, some people will still get fevers, chills.  So when you feel sick, and if it hasn’t been explained, and it’s been going on for not just a handful of days or even weeks, but when it starts to go on for months, that’s usually evidence that there’s some sort of persistent infection. And there really aren’t too many bugs that do that. So Lyme and some of these other co-infections that you can get through a tic bite tend to be associated with these long term effects.

                           So those chronic rheumatological symptoms, even things rheumatoid arthritis, lupus. A lot of autoimmune diseases have been associated with Lyme disease. And so it’s possible that Lyme really is the trigger or the catalyst for things like Multiple Sclerosis, Parkinsons, and Alzheimers.  If you go to your doctor and you ask him “Well, gosh, I’ve been diagnosed with MS. Okay, well why?” They’re not going to have a clue, and I think there’s some pretty good evidence in the literature that Lyme at least can be one of these organisms that triggers that kind of problem.

Dr. Weitz:            So, if Lyme is a trigger for some of those problems, if you go back and address the Lyme, will that help that condition, like MS or some of the other conditions you mentioned?

Dr. Ingels:            Absolutely, and I’ve treated several patients who were diagnosed with multiple sclerosis, that we also found out they had Lyme disease, and in treating their Lyme, their MS improves and sometimes even goes away. All the symptoms, and I’ve even had a couple of patients where they’ve had a repeat MRI, that’s part of how you diagnose MS, and there’s typically specific lesions you see on the brain, and we’ll see those lesions go away.  So was it MS?  Was it Lyme disease?  It gets to be a bit complicated, and I think the neurologists out there might have a different opinion on this, but a lot of these conditions are really descriptions, and they don’t specifically tell you why you have that condition. But again, I think there’s been some pretty compelling evidence that Lyme disease can become a trigger for autoimmunity. And whether it’s affecting your joints, or affecting your brain, that seems to vary from person to person who gets Lyme, but again, a lot of the issues that come up with chronic Lyme disease, there’s really this capacity for it to trigger autoimmune problems.

Dr. Weitz:            Is that because essentially when we’re dealing with Lyme disease, your chronic Lyme disease, we’re really not so much dealing with an infection, but with a condition of immune dysregulation?

Dr. Ingels:            Yeah, you know I think the infection is the initial problem, that’s why people feel acutely ill when they get affected. But the longer it stays in your body, there’s a concept in immunology called molecular mimicry, and what that means is that there’s a molecule on the organism that’s similar to a molecule that’s in your own body. So the immune system tries to fight the infection, it accidentally starts fighting your own tissue.  And so whether it’s in your joints, your intestinal tract, your skin, it really can affect any tissue. But again, there’s been some good evidence and studies that Lyme has this capacity to trigger that autoimmune event. And I think in most cases the brain and the neurological tissue just happens to be more affected perhaps than others.  So any of these autoimmune conditions, whether it’s Lyme, and there’ve been a lot of other organisms that have been identified as trigger autoimmunity, I think it’s important that people start investigating that microbe trigger. And fortunately we have a lot of different ways we can evaluate them.

Dr. Weitz:            Well when you suspect Lyme disease, what’s the best way to confirm that, or test for it?

Dr. Ingels:            The testing is a bit controversial, the CDC recommends what’s called a two tiered testing, where the first test is a Lyme screen, it’s a blood test, it’s an antibody test. And if that test is positive, it then flexes over to a more detailed test called a western blot.  The general rule is if your Lyme screen is negative, they don’t even do the second test. I was a microbiologist before I was a doctor, I used to work in a lab and do these tests, and in the laboratory world, a test to be a good test has to be both what we call sensitive and specific. So what are the likelihood it’ll pick up the disease if you have the disease? And if the test is positive, what is the likelihood that that’s an accurate result and not a false positive?

Dr. Ingels:            And a good test should be at least 95% sensitive and specific. Well, what we find with the Lyme testing is that it’s about 40% sensitive, which means it doesn’t even pick up half the people that have Lyme disease. In our world that’s a terrible test, so I find it ironic that in 40 years of doing Lyme testing, we’ve really never changed that criteria. And we’ve learnt so much about Lyme disease that it just seems odd that nothing has really changed in how we’re looking at Lyme.  So if you go to the CDC’s website and read, Lyme disease is really what we call a clinical diagnosis. It’s based on your symptoms, particularly if you live in an area that’s endemic for Lyme. Plus you have to rule out all these other things like autoimmune disease. And when you’ve done that, that sort of starts narrowing it down. If your Lyme test comes back positive, false positives with Lyme tests are actually quite rare, but false negatives are extremely common.

                           So the bottom line is that a negative test through the conventional testing methods doesn’t necessarily exclude the possibility of Lyme. Now, the good news is we do have other labs out there that do more sensitive testing, they use different test kits. They also report it in a slightly different way, that increases your likelihood of picking up Lyme.

                            So, if someone’s really interested in getting tested, I recommend going to one of these labs that does better Lyme testing, and probably forgoing the standard Quest, Lab Corp test, just because of the small likelihood of picking it up, particularly the further you get away from being infected. Because we’re measuring antibody levels, your antibody levels should be highest closest to the time you get infected. The further you get away from that, immunity naturally wanes. So the likelihood of picking it up two years, four years, ten years after you’ve had exposure goes way down.  So, I think if you use some of the other labs out there, you increase your likelihood of picking it up.

Dr. Weitz:            Have you used Dr. Vojdani’s Immunoscience lab?

Dr. Ingels:            I have used his occasionally. There’s a lot of good labs out there, Immuno science I think does a good test. IGeneX, are probably the one that most people in the Lyme community use. They’ve been around a long time and they do very good testing. I also use a lab called Medical Diagnostics Laboratory in New Jersey. I like them, I think their testing is equivalent to IGeneX, plus they bill insurance. So for a lot of our patients who’ve already paid so much out of pocket, it’s nice that you can actually bill something to your insurance plan.

                           And then there’s a new lab that just came out, in fact I’m actually on their scientific advisory board, called Global Lyme Diagnostic. And the doctor that developed their test is actually a vaccinologist, and he was tasked to find a vaccine for dogs, for Lyme disease. But to create a vaccine you have to find something that’s very common to all these different strains of Borrelia. We know that in the United States there’s about 100 different strains of Borrelia, and there’s about 300 strains worldwide. We don’t even know how many of them are clinically relevant, our guess is it’s probably somewhere from 10 to 12.  So he had to find a sequence of part of the organism that’s common to all Borrelia, and so instead of making a vaccine, he actually turned it into a laboratory test. And because Borrelia Burgdorferi is the dominant strain, there are these other strains like Borrelia Miyamotoi, and many others. So this test actually looks at all the different strains of Borrelia.

Dr. Ingels:            The testing, I did mention it earlier, but the testing that’s available through what the CDC recommends, only really looks at Borrelia Burgdorferi. So if you happen to have another strain of Borrelia, either your test might be negative, or it might look kind of gray where maybe you get one or two antibodies, but not the full complement that you might expect.      So this is where we come back that a negative test doesn’t necessarily exclude the possibility of Lyme, because maybe you have a different strain of Lyme that’s not Borrelia Burgdorferi.  So the good news is we’re getting better in our testing, we have a lot more available to us, but again, at the end of the day, that piece of paper is really only confirming what we really already suspect, and you really have to go based on patients symptoms.

Dr. Weitz:            And is it valuable as well to test for some of the common Lyme co-infections like Bartonella, Babesia, et cetera?

Dr. Ingels:            Absolutely. So whenever we’re working anybody up for Lyme disease, you want to test for all these other co-infections. We know that in New England, where I spent part of my time, about a third of the tics that have Lyme disease also carry some other infection. I go to these Lyme conferences every year, and it seems like that list of things that tics spread gets more and more every year.  I don’t even know how practical it is to test for everything, now that we know that there’s a lot of bacteria, other viruses that can be transmitted through these tics. So we tend to go for at least the big ones, and then depending on what we find sometimes we have to start looking at the more obscure things that you can get through tic bites.

           But things like Bartonella, which is a bacteria that we typically associate with cat scratch fever. So even if you never have a cat, you can get this bug through a tic bite. Babesia, which is a cousin of malaria, it’s a blood parasite so it causes a lot of malaria like symptoms where you can get cyclical fevers. And there’s a thing called air hunger where you just feel like you can’t get a deep breath. Anaplasma is actually quite common in the North East, which is another bacteria. There’s Ehrlichia, there’s Tularemia, there’s a lot of other things.

           And I think the one that’s come out in the last year, especially in New England, is there’s a virus called Powassan virus. And viruses, because they behave differently than bacteria and they’re able to penetrate your cells a little more easily, can potentially cause a lot more problems. So Powassan was scary this year because there were actually several deaths associated with Powassan.

Dr. Weitz:            How do you spell that?

Dr. Ingels:            It’s P-O-W-A-S-S-A-N.  So for someone that’s got a really high fever, very acutely ill, particularly if you know that there’s a tic bite, there are a couple of labs now that are testing for Powassan virus.  But antibiotics don’t do anything for viruses, so I think what happened in those few cases is that they were probably treated with antibiotics, but it’s not the appropriate treatment, and unfortunately it was lethal in those cases.  Again, it’s an emerging virus, we haven’t had a lot of cases, but the few cases we had have been very severe.  So, it’s just one of those things that depending on how people are presenting, you have to rule out the possibility of having more than just Lyme, and look at the breadth of all these different infections you can get through a tic bite.

Dr. Weitz:            Can you talk about your five step plan for overcoming Lyme disease?

Dr. Ingels:            Sure. So, you know, I laugh when I say it out loud, a five step plan, it makes it sound so easy. Lyme disease is actually very complicated, but I was trying to condense it into a way that could really help people focus on some of these things that I see as really being obstacles for people getting better when they have Lyme disease. So, I don’t mean to simplify Lyme in any way, but this an easy way for people to think of it.

                             So the first step is really about treating the gut. And the reason is that your gut accounts for about 80% of your immune function. So if your gut’s not functioning well, your immune system’s not going to function well. And so many people I see with Lyme have chronic constipation, chronic diarrhea, poor digestion, gas, bloating, the whole gamut of things.  So, it tells me a little bit that your body’s ability to digest your food, absorb your food, might be compromised. And since you need all that nutrition to drive the rest of your engine, we want to make sure that all that’s working properly. So it’s important that people take stock of how their elimination is, their digestion, and you should be having at least one to two bowel movements a day.    I’ve had doctors tell patients that they poop once a week “Oh no, that’s fine. That’s normal.” That’s really horribly constipated, that is not normal. So it’s a good idea to take stock of how you’re eliminating, and then again I talk about in the book, there’s a lot of things we can do nutritionally to help support better bowel habits.  So things like glutamine can be very nutritive to the gut, to help heal the large intestine. Of course probiotics can be beneficial to help repopulate the gut, particularly if you’ve already been on antibiotics for Lyme disease. Antibiotics of course do set the stage for having an imbalance in your gut floor, or creating an overgrowth of yeast. So I use a lot of probiotics. And then we can use things like fish oil, and curcumin as natural anti inflammatories to help quell any kind of inflammation of the gut.

            So the first step is really let’s get the gut in good working order. The second step is really about diet, and I’ve tried a lot of different diets with people. There’s the paleo diet, the anti candida diet, of course the keto diet is very popular now. And having tried a lot of different things, the diet I’ve found for myself and for my patients that seems to work best is what we call an alkaline diet.

Dr. Ingels:            And what that means is that you’re eating foods that help promote better alkaline PH in your body. So for people who don’t know, PH tells us about how acidic or how basic your body is. It talks about your body chemistry. And virtually all your cells, with exception of your stomach, your bladder, and for women the vaginal area which is very acidic to help protect against outside invaders, the rest of your body is actually very alkaline.  So, by eating certain foods we can help keep that PH more balanced. And we get exposed to so many things in our world that make our body very acidic, whether it’s chemicals, medication, acid rain of course affects the PH of the foods that we eat. So that tends to make us acidic. And it’s a lot of details to simplify it for our purposes here, it’s basically eating a mostly vegetarian plant based diet.  We try to limit animal intake, so that’s meat, fish, shell fish, eggs, we try to keep that down to about 20% of your total dietary intake for the week. And then we eliminate all junk foods, all dairy, coffee, I know, I love coffee, but I found for myself even a few sips of coffee would trigger inflammation in my body. So if you’re a coffee drinker, it’s a good idea to start working on weaning that off.

                          And it’s not really about the PH of the food, it’s about what the food does in your body. So for example lemons and limes are very acidic, if you squeeze them on a PH strip they’ll turn very acid. But in your body they break down in a way that actually makes your body very alkaline. So starting your morning with a glass of lemon water or lime water is actually a great well to help start moving your body in a more alkaline state.  And this is one of these things where people can buy PH strips and they can do urine testing before they eat in the morning and later in the day. And they can monitor their progress, and kind of show how their body’s moving, whether it’s more acidic or more alkaline.  And it takes a little time and a little practice, but once people start to shift their diet we’ll see that they’re able to maintain that body PH a little bit better.

                         So that’s the second step. The third step is really about going after the active infection. So I talk about a lot of herbal protocols that I’ve used on myself, and I’ve used on my patients, to help treat the infection. I think when a lot of people get Lyme they feel like antibiotics are the only option, and in acute Lyme I’m a big proponent of antibiotics. I think for a lot of people it helps get rid of the infection before it ever gets to be a problem. But once you’ve gotten into the chronic stage there’s actually not very good evidence that antibiotics are terribly effective.       And I’ve heard people, and I’ve seen people who have gone on antibiotics and did okay, but I’ve seen a lot more people that went on antibiotics and got worse, or it did nothing at all. Or they had a temporary benefit, and as soon as they came off the antibiotics they started to relapse again.

                       So I talk about some of the herbal protocols I’ve used, if you go online and read about herbs there’s probably eight or nine different protocols out there. The top two that I tend to use, again, Dr. Zhang has a Chinese herbal protocol, that’s what I used to pull myself out of the weeds. And in Chinese medicine they always use formulas, they never really use single herbs.  So I like his protocol because it really addresses the gamut of everything Lyme does to your body. So not only does it go after eradicating the organism, it helps improve circulation, it helps boost your immune system, it’s anti inflammatory, it’s analgesic. So it does all these over things that Lyme can do to the body. So I think it’s really one of the more comprehensive herbal protocols out there.

                       And I’ve also used a variation of Dr. Cowden’s protocol. So Lee Cowden was a cardiologist in Dallas, I think he’s retired now, but he created a series of tinctures that come from the Amazon. And I like them because they’re liquid, so they’re great for kids who have Lyme disease that can’t swallow capsules. And his protocol’s actually been studied by a research at the University of New haven, here names Dr. Eva Sapi. And she’s actually found that those herbs worked better than antibiotics. So if people are concerned “Oh Gosh, herbs aren’t very effective,” well she’s actually proven that’s not the case.

                      So, going after the active infection is important. People ask all the time “Well, do you ever really get rid of Lyme?” My personal opinion is I don’t think so. I think it’s kind of like when you get chicken pox when you’re five years old and then get shingles when you’re 55, it’s the same virus that’s stayed in your body for 50 years. Oh, and the immune systems become compromised, it can start to become problematic.  So I think dealing with Lyme is really about controlling the organism, keeping it at bay, keeping it from getting to the point where it tips the scales that you become symptomatic. But because we can’t measure the organism directly in your body, at least not easily, we don’t really know if you completely eradicate it 100%. But my feeling is if we can get you to a point where you’re symptom free, then we’ve done a positive thing.

                   The fourth step is really look at things around your environment that undermine your immune system. So this is looking at things you put on your body, and in your hair, personal hair products that might contain potential toxins. Cleaning chemicals around the house, things you spray on your lawn. All these different chemicals can have a negative impact on your immune system, and we want to give your immune system every fighting chance it can.

                    And the one thing I probably talk the most about in that part is mold. Pretty much no matter where you live in the country, mold can be a bit of an issue. And symptoms of mold exposure or microcytotoxicity look almost identical to Lyme disease. When I have patient where we know they have Lyme disease, we’ve been doing Lyme treatment and we’re really not seeing a lot of progress, the next step is to look and see if mold might be part of the problem, because the treatment of course is going to be very, very different.  So evaluating your home, making sure your home is safe and free of mold. It’s always a good idea, particularly if you live in areas where there’s a lot of moisture or humidity, they tend to be at higher risk of having mold. And you could have a pinpoint hole in your roof and never see it through your walls, but there’s enough water that’s collecting there that creates a mold issue. So always a good idea to check that out.

Dr. Ingels:            And then the last part of it is really looking at lifestyle factors. Looking at things like how well are you sleeping. We know that your brains and your neurons repair themselves when you’re in that deeper start of sleep, and a lot of people I see with Lyme disease will tell me that after they got Lyme they started sleeping very poorly.  So whether they’re not getting enough sleep, or not getting a deep sleep, we have to find ways to encourage better sleep habits, to get you to that deeper start of sleep, because that’s when your brain and your body’s really going to start repairing itself.  And then looking at things like exercise, moving your body. I’m sure you know in your practice too when you get people who are chronically ill, the last thing on earth they want to do is move their body. But trying to find ways to get your blood moving is part of the way that we can help bring oxygen, nutrients to the tissue.

                           So, even for people who are in wheelchairs and are very limited in their abilities, if find that you can do stretching, you can do very mild forms of exercise like Tai Chi or Chi Kung, that are very low impact, but they still have a positive benefit on both your physical body and your mind.  And with regards to the mind, I think teaching people how to deal with the stress of having a chronic illness is really important. We tend to focus so much on the physical aspect of Lyme disease, we kind of ignore that psycho-emotional aspect of Lyme, and what it’s like to be chronically ill. And the impact it has on you, your spouse, your loved ones, your family, your friends. It’s very stressful, and at some point your friends and family get tired of hearing about it.

                           So I think it’s really important that people have a good support network, have a system in place, whether it’s a therapist or a support group they’re involved with. But have some outlet that you can share your experience openly and without judgment. And just finding different ways to help manage stress.  So, that kind of rounds out the five parts to the plan, and then in the book I have one chapter that talks about various therapies you can do in conjunction with your healthcare provider. But those are therapies that really need to be medically supervised, so it’s something you’ll want your practitioner on board with. 

Dr. Weitz:            Yeah, I read through that section and there was quite a number of interesting therapies. One that I didn’t see there that a lot of Lyme practitioners talk about is Ozone. What do you think about the use of intravenous Ozone?

Dr. Ingels:            My experience with oxidative therapy is both Ozone and hyperbaric oxygen, is it tends to be I think more of a short term benefit. I went through Ozone myself, I would feel better for a day or two and then I was right back to square one. And I’ve had several patients that have had similar experiences.  I think Ozone probably has a lot of benefit, particularly for people with acute Lyme disease, because it does have a nice anti microbial affect. But if you’ve gotten to the point where it’s not just the infection anymore, it’s really more of an auto immune issue, I don’t know how well the oxidative therapies are going to help with flipping the switch on the autoimmune process.  So again, my experience with oxidative therapies has been perhaps a little bit disappointing, and I know a lot of my colleagues who do Ozone therapy that tell me how wonderful it works. Unfortunately it hasn’t been my personal experience or my experience with my patients.  So, the other thing we get into is most oxidative therapies tend to be pretty expensive for people, and it requires if you’re going to it you kind of have to do quite a bit of it to get the potential benefit anyway. So again, I find in my population that the cost and the time of doing it for most people is somewhat prohibitive.

Dr. Weitz:            So of all those specialized therapies that you have in that section, which is the one that you would think would be most useful adjunct for most people?

Dr. Ingels:            The one I think I get the most bang for the buck is what we call Low Dose Immunotherapy. Low dose immunotherapy, or what we call LDI for short, was developed by Dr. Ty Vincent. He’s a medical doctor in Hawaii, and it’s basically build on the concept of using a microbe to help turn off the reaction to what that microbe’s triggered.   So in my ways it’s a bit of like homeopathy, of what we call isopathy. We basically take a dead bug, we dilute it out, and we mix it with an enzyme called Beta-glucuronidase. And we’ve found in the allergy world is that this enzyme has the capacity to alter the way your immune system reacts, to whatever it’s mixed with.   So if we mix it with dead Lyme, dead Bartonella, dead [inaudible 00:30:59] virus. If that organism has triggered any kind of auto immune issue, we think it’s working at the level of the immune system that switches that, or flips that switch, to try and help turn off auto immunity.  So I’ve had a lot of patients who’ve undergone a lot of different therapies for Lyme. Didn’t have a lot of success, and this is one therapy that really helped turn the tide for them. So there about 100 or so practitioners I think around the country that are doing this therapy now. So if people get stuck in their Lyme treatment, I think this is a great therapy.

Dr. Weitz:            And for people wanting to learn more about Low Dose Immunotherapy, a few episodes ago I interviewed Dr. Karima Hirana, specifically we talked about Low Dose Immunotherapy.  

Dr. Ingels:            Yeah, that’s wonderful. I know she does a lot of it in her practice, but, again, it’s one of these things that depending on the organism, so whether it’s Lyme or Bartonella Babesia, we can really use it for any of these microbes that might become immune triggers. In some cases it might be more than one, so if you’ve got Lyme and Bartonella, or Lyme and Babesia, we can use these different dilutions to help figure out what’s causing the problem.

Dr. Weitz:            So, of your patients in your clinic, I’d like you to give me just an estimate of the number of patients with Lyme who go through your five step protocol, how many of them are cured permanently would you say?

Dr. Ingels:            Oh gosh, the C word! Cure is a tough word. I mean I’d say probably 80% plus of my patients improve. In terms of what percentage get to the point where they’re 100% symptom free, that’s hard to measure because it happens over the course of such a long time. I’d probably say we can get 50% plus to the point where they’re symptom free. I have a lot of other people that get a lot better and sometimes they still have a nagging symptom.  It’s so hard because … It’s a little bit like filling up a bathtub and draining it at the same time, there’s so many other things going on in people’s lives and world that undermine their immune system that we’re constantly trying to battle all of those different aspects of what they’re eating, what their lifestyle’s like, what their job’s like.

                            My office is in Connecticut, I’m in suburban New York City, so everyone I work with there is pretty much a Wall Street person. You know these Wall Street people work ridiculous hours, and they’re up early for the stock market. So how easy is it for your body to heal when you work 14 hour days, and you’re commuting four hours a day? It’s tough.  So I think that often becomes a limitation on people’s ability to really get well, and sometimes it’s just a practical matter that it’s a little bit challenging to overcome.   But I want people to understand that there is hope, there is a way to get there, and again, I feel like I’ve had as good success, or more, than most other practitioners, because, again, we’re not just focusing on killing the bug, we’re really trying to expand and deal with all these other issues that Lyme creates in the body.

Dr. Weitz:            I know it’s in your book after you go through these five steps and talk about a few other things, you go back and explain how a patient would go back through those five steps again, and elaborate on some of the details that you didn’t elaborate on the first time.

Dr. Ingels:            Yeah, you know when people go through that five step process, if you get to a point where you find that you’re not really getting the improvements you expect, I think it’s important that first and foremost is it really Lyme or is there something else going on? My experience has been when we go through this process, and particularly for people who get no improvement at all, my thought is that there’s probably something else going on beyond Lyme.  And again in some cases it may be that they’ve had some other exposure that we didn’t identify, there was some other chronic stressor that I didn’t know about, that we weren’t really dealing with. So the first step is really look at other aspects of your life that might be contributing to the way that you feel.

                           And then beyond that, I always ask people to be really honest, I mean have you really done everything that we asked you to do? And in some cases people are like “Well, kind of. I kind of followed the diet, but not really, because it’s really hard.” So if you only do it 50% you might only get 50% improvement. So it’s important to take stock and be honest with yourself, are you really following the steps?  But for people who legitimately follow those steps, do everything we ask, get stuck, again, first and foremost I think it’s just a function of looking at other things that might be contributing to their health. And again, sometimes we’ll do other blood tests, other imaging studies, and we’ll find there actually is something else going on that we didn’t identify initially, and that might explain.   So work with your healthcare provider in trying to dig a little bit deeper and find those causes.

Dr. Weitz:            I noticed when you were talking about the gut, I wonder if you don’t find sometimes that patient with gastrointestinal symptoms like gas, or bloating, or discomfort, et cetera? Maybe they have some form dysbiosis, or small intestinal bacterial overgrowth. Do you ever have to go back and treat that, and clear that out in order to get a complete recovery?

Dr. Ingels:            Yeah, and the one you just mentioned there, SIBO, small intestinal bacterial overgrowth, is a very common one. In fact, I had one patient who she went through her Lyme treatment, she did well, and she got maybe 70% better, but she was still having neuropathy, numbness and tingling in her feet. And then we did a SIBO test and she was positive, and when we treated her SIBO her neuropathy went completely away.

                            So, yeah, we talk about gastrointestinal health, I mean part of my standard workup is we typically do stool testing on pretty much everybody with Lyme, just to make sure. And particularly if you’ve been on antibiotics, but if there’s a lot of gas, bloating, reflux, symptoms that might suggest SIBO, we might also do a SIBO test at the same time just to try and rule that out, because if you’ve got SIBO and you keep doing all the other Lyme treatment, yeah, you’re going to hit a wall at some point because you haven’t really addressed that issue.

                            So when I talk about gastrointestinal health we’re really talking about from top to bottom, from your mouth all the way down. So what’s going on in the stomach, looking at H Pylori, looking at SIBO, looking at any kind of parasite infection, overgrowth of yeast, all of that becomes very important in how well your gut’s functioning.

Dr. Weitz:            Awesome, Darin, I think we’ve got a lot of very useful, interesting information from you today. Thank you for sharing that. For listeners, viewers, practitioners, who’d like to get hold of you, what’s the best way for them to find out more information and contact you?

Dr. Ingels:            The best way is just to go to my website, it’s dariningelsnd.com, D-A-R-I-N-I-N-G-E-L-S, N as in Nancy, D, .com. And we’ve got a lot of great information, we’d love people to sign up for our newsletter. And I’ve also got a free chapter of my new book that you can download, or we also have a free e-book of my top 10 immune boosting recipes, that we’d love people to have.  So please sign up, follow us, and we’d love to help share some more information about Lyme disease and other things that we deal with.

Dr. Weitz:            And where can they get The Lyme Solution

Dr. Ingels:            The Lyme Solution, well as of now, I’m one week away from when it actually comes out, so it’s available through all your major book retailers like Amazon or Barnes & Noble for pre-order. But the book itself drops on March 27th.

Dr. Weitz:            That’s great, we’ll be looking for that Darin. Thank you for joining me today, and I’ll see you in a few months at our functional medicine meeting.

Dr. Ingels:            All right, thanks Ben.

Dr. Weitz:            Thanks.

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