In the past 30 years, the prevalence of Lyme’s disease has grown exponentially and today Lyme-carrying ticks are found in nearly every state in the nation, with concentrations in the Northeast and parts of the Midwest. Lyme’s patients present with diverse and hard-to-treat symptoms and controversy remains about the duration of antibiotic use in newly affected patients—and the efficacy of using antibiotics at all in chronic Lyme patients. In this podcast, Dr. Fitzgerald talks with Dr. Darin Ingels, author of “The Lyme Solution: A Five-Part Plan to Fight the Inflammatory Autoimmune Response and Beat Lyme Disease.” Dr. Ingels’ first patient was himself and today he helps patients across the country heal from Lyme disease. In this podcast, you’ll hear:
- About Lyme as a clinical diagnosis and the symptoms specific to Lyme’s.
Diagnosing microtoxicity v. Lyme
- How to prevent tick bites and the efficacy of herbal tick repellent
- A discussion of antibiotic use in Post-Lyme Syndrome patients
- Ingels’ advice on the length of antibiotic treatment for acute Lyme
- How to treat Lyme’s patients who are asymptomatic
- The pros and cons of different Lyme diagnostic tests and which tests Ingels uses in his own practice
- Specific herbal interventions, and specific supplement brands, for healing Lyme’s
- The best diet for Lyme’s patients
- The one ESSENTIAL lifestyle factor for healing Lyme’s
Dr. Darin Ingels, ND, FAAEM, is a respected leader in natural medicine with more than 26 years experience in the healthcare field. He is Board certified in Integrated Pediatrics and a Fellow of the American Academy of Environmental Medicine. Dr. Ingels has been published extensively and is the author of “The Lyme Solution: A 5-Part Plan to Fight the Inflammatory Autoimmune Response and Beat Lyme Disease,” a comprehensive natural approach to treating Lyme disease. He specializes in Lyme disease, autism, and chronic immune dysfunction.
- The Lyme solution
- Dr. Ingels Website
- Dr. Zhang Website
- MDL Labs
- Global Lyme Diagnostics
- Armin Labs
- Cyrex Labs
- Great Plains Labs Mycotoxin Test
- Dr. Zhangs Herbs
- Prepdish, Allison Schaaf, Alkaline Meal Plan
Biotics Research Corporation utilizes “The Best of Science and Nature” to create superior nutritional supplements, available exclusively to healthcare professionals.
By providing meticulously formulated nutritional supplements and valuable resources, Integrative Therapeutics promises to enrich your patients and embolden your practice.
Dr. Kara Fitzgerald: Hi, everybody. Welcome to New Frontiers in Functional Medicine, where we are interviewing the best minds in functional medicine and today is no exception. I’m your host, Dr. Kara Fitzgerald. I am talking with Dr. Darin Ingels today. He’s the author of a great book, we’re going to drill down into it. It’s called, “The Lyme Solution: A Five Part Plan to Fight the Inflammatory Autoimmune Response and Beat Lyme Disease.” That was published by Avery in March of this year.
Darin Ingels is really kind of a doctor’s doctor. A lot of us refer to him for some of these challenging cases, such as Lyme and its ability to increase one’s vulnerability to mold and mycotoxicity, et cetera. He’s just done a lot of really good work in this arena. I was introduced to Darin by Dr. Amy Myers and have appreciated getting to know him. He’s talked to my journal club on a number of different calls just updating us on his unique approach. Let me give you a little bit about his background: He’s a respected leader in natural medicine with more than 26-years background. He’s board certified in integrative pediatrics and a fellow of the American Academy of Environmental Medicine. Again, he’s just published his book on Lyme disease; we’re going to talk about today. It’s a comprehensive natural approach to treating Lyme. He specialized in Lyme disease, autism, and chronic immune dysfunction. He uses diet, nutrients, herbs, homeopathy, and immunotherapy to help his patients achieve better health. Dr. Ingels lectures all over the country and probably in other countries as well and we are so glad to be picking your brain today, Darin. Welcome to New Frontiers.
Dr. Darin Ingles: Oh, good morning, Kara. Thank you for having me.
Dr. Kara Fitzgerald: Talk to me about your background. How did you get into focusing on Lyme?
Dr. Darin Ingles: Well, it’s kind of interesting. Actually, before I was a doctor I was a microbiologist. I actually was a clinical laboratory scientist I think is the technical name and I did microbiology and immunology testing at a big teaching hospital in Chicago. So I actually used to do Lyme testing as part of my job, so I’ve got a very broad background in laboratory testing. And then about three weeks before I opened my own practice in Connecticut I got infected with Lyme Disease and I got to experience what most people with Lyme experience. I had a very stereotypical case of Lyme with very high fever, headache, joint pain, had a big bull’s eye rash on the back of my leg. Really every symptom you read in medical textbooks.
So I went on a standard treatment of doxycycline and after four days of treatment I actually felt pretty well. But as a new business owner I was doing everything and working 10-12 hour days, and after about eight months of doing that I started to relapse and get symptoms again. So I went back on antibiotic therapy and it didn’t help, and I changed antibiotics and it didn’t help. Over the course of the next eight or nine months I kept changing antibiotic protocols and actually continued to get worse and worse. I was fortunate that I had a handful of patients who had seen a doctor in New York City named Dr. Zhang, who’s a Chinese medical doctor and herbalist. And I went to see him and he started treating me with Chinese herbal medicines and after really a handful of weeks I started to improve significantly. So it was really my wake up call that I needed to come back to my naturopathic roots and really examine what I was doing in my life and why was this was happening. And it was really about getting better sleep, and eating well, and going back to herbs.
I took about two years after that point to feel like I really got my life back, but eventually I did and I started functioning at a really high level again. So it was really that personal experience of trying various therapies and what worked and what didn’t work. And then I started applying what I did for myself to other Lyme patients and found that they were responding very well. As I started digging into it a little deeper and realizing that Lyme is such a terribly complex medical problem and it’s far beyond an infection, and looking at all the immunological things that happen with Lyme, and just started applying those principles to treatment and I found that people really started getting better faster. So that was really the impetus behind writing the book is I just wanted to be able to have a way of sharing my experience with Lyme personally and what I’ve been doing with patients.
Dr. Kara Fitzgerald: Yeah, that’s so good. I know there are nice reports coming out of the work that you’re doing, and I’ve actually referred to you myself. All right, so I want to jump in because I need to mine your brain for your protocol as much as we possibly can in our time together because I know everybody, mostly clinicians, are listening to this and they’re really wanting to know. Especially with your personal experience, which is a good, important story. All right, my first question is as you know the CDC just released their morbidity and mortality weekly report with some pretty depressing statistics on the meteoric rise in tick-borne and mosquito-borne infections. In fact, yesterday, not yesterday, a few days ago actually, our office has been shut down because we were in the middle of the Connecticut tornadoes as random as that is. We haven’t had any power around here. But right before that happened there were a group of women walking, our office is surrounded by the Pootatuck forest. We’re literally just planted in the woods here. And they were walking on the pavement and I said, “You know, there’s an awesome trail back there. It’s beautiful. It goes along the river and there’s a nice trestle.” And they said, “Yeah, yeah, yeah. We’ve walked on that many times, but it’s tick season.” So they were marching back and forth on the ugly, hot pavement here.
So it’s depressing. And people are avoiding the woods. I go out in my grass and then I’m checking myself for ticks. It’s anxiety provoking. So given what’s going on, just talk to me about what you recommend to patients on prevention.
Dr. Darin Ingles: Well, the thing with ticks is that they need to have contact with you to really get on your skin and potentially infect you. So ticks don’t jump, so it’s usually when you’re brushing up against leaves or foliage that if the tick’s sitting there and then you brush up against it it lands on you and eventually can make way to your skin. So the best prevention really, especially if you’re going to be hiking out in the woods, of course I always recommend if you’re hiking on a path that has a path cut out stay on the path. Don’t go out into the deeper, unmanicured part of the trail because you’re more likely to come into contact with these ticks. So staying on the trail is definitely helpful, but even then, especially in Connecticut, I would recommend wear long clothing when you’re out in the woods. It seems kind of counter intuitive, especially when it’s summer and it’s hot and humid and it’s really kind of uncomfortable, but that clothing does provide a pretty significant barrier against the tick. So long pants, shoes, socks, long sleeved shirt. And if you’re going to be going anywhere that might have some overhanging brush even a hat.
The other nice thing is that there’s some really great natural tick repellents that you can get online, or actually at a lot of health food stores. And you can spray yourself, spray your clothing before you go out into the woods. That’s also going to be an extra layer of protection. And I get this comment a lot from people that say, “Well, gosh, natural stuff, does it really work?” The government actually studied it and yes, it does work. There’s a lot of great essential oil formulas relative to using DEET, which we know is terribly toxic and of course you never want to apply DEET directly to the skin, which I hear people do all the time. It’s very toxic, very dangerous. But we’ve got different combinations of cedar and lemon grass, and tea tree oil, there’s just a whole bunch of them. Clove oil, that’s been shown to be a really excellent tick repellent. So you can pick up one of these products, but it really is about being vigilant. And if you’ve been outside, and particularly if you’ve been hiking in the woods, when you get home you want to do a head-to-toe tick check. These ticks are extremely tiny, they often look like little flecks of dirt, and particularly if you’re out with your kids you want to make sure that you strip them down when you get inside and comb through their hair and look at all their skin.
Ticks like the dark, most areas of the body. So think about the armpit, the groin, the back of your knees, the hair line, behind your ears. These are the types of places that people often get bit, so those are the places you want to hone in and look at.
Dr. Kara Fitzgerald: Okay, all right. So you’re not recommending woods avoidance, but just be smart about it. And you think that the essential oils will help? I’m sure a lot of people are going to appreciate hearing that. Okay, so you’ve gotten the tick bite. Then what?
Dr. Darin Ingles: So if it’s an initial tick bite this is a case where I think antibiotics are very appropriate. We’ve got plenty of good research and clinical evidence that when you catch it early antibiotics have a very good chance of eradicating the disease before it ever gets to the point where it causes chronic problems. So I think the biggest problem most people run into is that they don’t know they got bit, so the number of people who are able to recognize Lyme Disease early is probably much smaller than we think. So people who get classic Lyme Disease, the standard features, I think antibiotics are very appropriate. For the people who perhaps got bit months or even years ago, I think the protocol needs to be a little bit different. I think between what I’ve observed clinically and what we find in clinical research is antibiotics for people that have what we now coin chronic or persistent Lyme Disease, the CDC calls it Post-Lyme Syndrome, there’s very little evidence that antibiotics at that point are really going to be of much benefit.
Dr. Kara Fitzgerald: Well, before we jump in there, I’m sorry, I’m cutting you off mid thought. But I assure you, we’re going to get over to chronic Lyme. What’s the protocol for an initial bite?
Dr. Darin Ingles: Well, if you follow the CDC’s protocol they say 21 days of doxycycline. Any of us who’ve been in the Lyme world for more than ten minutes realize that three weeks is not nearly adequate. And actually, the CDC recommendation is 10 to 21 days, so there’s some doctors that will just give you 10 days of doxycycline or amoxicillin and that’s the end of that. But the one thing you’re going to need to understand about Lyme is it’s an extremely slow growing organism. With any treatment the reason it’s longer than standard antibiotic therapy is because of the time in which the organism replicates. Considering most of the bacteria in your body replicate every 20 minutes, the research on Lyme suggest it replicates every one to sixteen days. That’s extremely slow. And if you consider a drug like doxycycline that’s not bacteriocidal, it’s bacteriostatic, so it doesn’t actually kill anything, all it does is it keeps the organism from replicating, so it’s still dependent on you having a healthy immune response to eradicate the infection on its own. So if you’re going to use doxycycline, I’d say six weeks is probably the minimum, and really I go until people are symptom-free.
So if you’re going to use amoxicillin really it’s the same length of time. You just have to really keep in mind how people are feeling. This concept that you just treat for a set period of time, which is the CDC recommendation, just clinically doesn’t make any logical sense. So you really have to continue the treatment until people really start to feel well. And by and large, I find most people with acute Lyme, by that six week mark many of them, if not most of them, do respond and feel better.
Dr. Kara Fitzgerald: Okay. And that’s sufficient? You don’t need to jump into the chronic stuff? Or I would imagine in a subset that you do.
Dr. Darin Ingles: We know that there’s a subset of Lyme patients that get what are called persister cells even with the appropriate treatment and even if you catch it early, they don’t respond to therapy and they move into that chronic Lyme phase. So there was a study that came out within the last month demonstrating that even after people had been on 21 days of doxycycline they still have evidence of Borrelia in their bodies. So we know that there is that subset that for whatever reason those particular organisms just don’t respond to antibiotic therapy.
Dr. Kara Fitzgerald: So you probably prescribe, I’m assuming you’ll do six weeks with doxy or amoxicillin for someone who’s just experienced a tick bite. Are you going to do that protocol whether they’re symptomatic or not?
Dr. Darin Ingles: I do not treat asymptomatic people.
Dr. Kara Fitzgerald: Okay, all right. Good.
Dr. Darin Ingles: You have to consider that your immune system has a wisdom to it, and again, there are some people who will get bit, their immune system does what you want it to do, it gets rid of the infection and that’s the end of that. So even when we see evidence of Lyme on a piece of paper, barring having clinical symptoms I would be very hesitant to treat people because treatment has its own set of risks as well. You can disrupt your microbiome and things of that nature with even herbal therapy. You have to consider: is the treatment going to be worse than the disease, so in my world unless people are demonstrating signs of Lyme there may be little benefit to treating them. Now, the argument could be made, “Well, gosh, if they got this infection it may manifest many years later.” And theoretically that may be true, but my experience has been that treating people early, often again because we have nothing to compare it with, we don’t have any symptoms that we can monitor as their progress, what length of time do you really need to treat at that point. So I think it creates more questions than answers, and again, I haven’t really seen evidence that you necessarily have to be aggressive for someone who may have had exposure that really has no clinical symptoms.
Dr. Kara Fitzgerald: That’s great. I think that’s a really, really important point. We’ve got a wildly sophisticated, very powerful immune system and if we’re generally healthy I think many of us are going to clear exposure. I appreciate that.
Dr. Darin Ingles: Yeah, I feel like if I tested everybody in New England for Lyme we’d probably find 75 or 80% of people may have evidence on at least the piece of paper that they’ve had exposure to Lyme. They all don’t have Lyme Disease, so what is the difference in why one person gets it, the other person doesn’t? And we’ll probably talk a little bit more about that later in our chat, but ultimately it really comes down to the terrain and what’s the state of your body and your immune system prior to that tick bite. That probably plays a pretty significant role on who and who does not end up with chronic Lyme.
Dr. Kara Fitzgerald: Yeah, right. As your story, as your own N of 1 demonstrated. Are you suggesting to people they send the tick off? I think I know the answer to this, but getting the tick tested?
Dr. Darin Ingles: Absolutely. Absolutely. And of course, it’s not 100%, but certainly if I get a tick sample and we send it off and we see there’s evidence of Lyme or co-infection, I would actually then treat if it comes back positive. Even if you have early exposure it can take up to a month before you develop symptoms, so if we get a tick result back within a week my feeling is let’s treat until proven otherwise, and whether that’s with herbal therapy or antibiotics depends on the patient, but I think instituting some kind of treatment early on as a preventive measure is probably wise. Particularly when the tick comes back positive.
Dr. Kara Fitzgerald: Got it, okay. So no symptoms, no tick, you’re not going to treat. But if they are still asymptomatic and the tick comes back positive then you’re going to treat, okay. Talk to me about the labs. I know we’ve had pretty lengthy conversations via email, you and our colleagues on how the heck to even evaluate. There’s a lot of tests, a lot of emerging tests, what are you using? How are you establishing Lyme Disease?
Dr. Darin Ingles: Yeah, so I think it’s really important that people understand and go to the CDC website and actually read this, I always point this out and people are always kind of shocked. Lyme is a clinical diagnosis, it always has been. It’s never, ever been a lab diagnosis. That test that was originally devised, and again, this is speaking as a clinical microbiologist who did this test for many years, this test was developed to monitor people who had known Lyme Disease. So when they first discovered that initial population of people with Lyme they drew their blood, they looked to see what antibodies were there, and then they said, “Okay, if you have Lyme you probably have these antibodies.” Understand, in 40 years of Lyme we have never, ever changed that criteria of the standard two-tier system that the CDC recommends. So I’ve really migrated away from the standard two-tier testing. I can tell you from my own experiences, when I was in the midst of Lyme, and again, I was a classic Lyme patient, my Lyme screen was negative. Completely negative. And my Lyme western blot lit up like a Christmas tree. So the Lyme screen is a horrible test, it’s not sensitive, it misses more than half the people that have Lyme. So if you’re following that guideline, stop. It’s a waste of time and money for you and your patient.
So I’ve gone with labs that use different test kits and have different reporting criteria. And again, the CDC’s reporting criteria to call a test positive is very narrow, and again, they don’t recognize the difference between antibodies that are Lyme specific and antibodies that aren’t Lyme specific. So what I’ve done in my clinic that I only use labs that report in a different way. I primarily use MDL, Medical Diagnostic Lab, in New Jersey partly because, A. they bill my patient’s insurance, which my patients love. And B. is that they actually send you a copy of the strip. Again, being a microbiologist I know how to look at it and I think any doctor can figure out pretty quickly how to read these. But they report each band and you can see the strength of each band. What a lot of people don’t realize is that there’s a cut off when they compare the patient to the control. And if the patient doesn’t have at least 60% of the intensity of each band they call it negative. Well, you’ll get the strip back and you’ll see they’re at 58%, 59% for a Lyme specific band and they call it negative. I’m like, “Really? 1% is the difference between you do and do not have Lyme?” That 60% threshold is very arbitrary, and I’ve yet to talk to a single pathologist who can tell me where that 60% came from.
And again, as a former lab person pretty much every test we ever ran would have a low, medium, and high control. And in this test it only has a high control, so it doesn’t appreciate that there’s a gradation of antibody responses. And so the assumption is that if you have Lyme you have a lot of antibody. I think MDL does great testing, IGeneX corp has been a leader in this world for a long time. They use a different test kit all together which is far more sensitive. I think the new player on the block that I’m actually now on the scientific advisory board for is called Global Lyme Diagnostics. And I think what’s exciting about this lab is that the doctor that developed this test is actually a vaccinologist, he was actually tasked to create a vaccine for dogs for Lyme Disease. And so he found a sequence called OSPA, outer surface protein A, which is actually what the old Lymerix vaccine, which they had for humans, which of course got pulled off the market years ago, that vaccine actually targeted that specific sequence. So what’s interesting is we know that we have upwards of 100 different strains of Borrelia in North America and about 300 strains worldwide, yet the test itself is looking only for Borrelia burgdorferi. So if you get exposed to one of this other strains it’s possible that test would be completely negative. It’s also possible to have cross reactivity.
So the thing with this OSPA is that it’s actually common to all Borrelia. So I think it casts a little bit wider net on looking at all the potential species of Borrelia. And I’ve run it in parallel with MDL and IGeneX and other labs, and even when those tests are negative sometimes this test comes back positive. So I’ll usually run Global Lyme Diagnostics and MDL, or IGeneX in parallel. And again, we’re just trying to get as much information as possible about exposure. And remember, that’s what this test is. It’s an antibody test, so an antibody test is just telling you you’ve had exposure. It doesn’t tell you you have Lyme Disease. If you had a test where you had these antibodies, particularly if they’re Lyme specific bands, and no clinical symptoms you can say, “Okay, well you’ve had exposure, but you probably don’t have Lyme Disease because you don’t have any of the symptoms.” So I think this is a thing people need to be really cognizant of when they’re dealing with Lyme is that just because you see it on paper doesn’t necessarily mean that you have Lyme. Lyme is a clinical diagnosis. So you always have to take into consideration a patient’s clinical symptoms. All that piece of paper is there to do is really validate your suspicion that that’s what’s going on, demonstrate that they’ve had exposure, and you really have to base it on the clinical symptoms.
Now the other lab which I think has been really interesting is Armin Labs. They’re out of Germany and I like their test because they’re not measuring antibodies. They’re actually measuring cytokine activity. And of course cytokines are going to be up regulated when there’s some sort of immune activation. So I think it’s a better marker about activity. And again, I’ve had some Armin Labs that come back negative, it doesn’t exclude the possibility. Actually, I was just on a Lyme chat board where a lot of practitioners were complaining that every single test was coming back positive. That hasn’t been my experience, but again, it’s just a tool. And I don’t know that you can put stock into any one lab, any one test. I don’t think it’s uncommon that often we’re doing several tests to try and sort out what we think is going on with Lyme and coinfection. But again, the Armin Labs is just a little bit different because it’s not looking at antibodies. So certainly for someone who might be very early in exposure I think that’s a great test to run because it can then take up for a month for antibodies to be made. So if you’re suspicious and it’s early you might want to run that lab first and see if you have any element of cytokine activity.
There’s a whole bunch of other labs out there. The ones I’m not really crazy about are a lot of the DNA technology ones. I think there’s some complications in that it’s all about the primer that gets used, and some of these primers are not necessarily specific to Lyme. I’ve come across a couple of labs where every single sample I’ve ever seen is positive, and again, that always makes me suspicious as a lab tech that is it reproducible, is it valid? I also get concerned that I know some of these labs aren’t necessarily validating their technology and there’s really no standard to compare it with. That also makes me a bit nervous. The other thing too is, again, if you get exposed to Lyme, even though you didn’t have Lyme Disease, if there’s fragments of that DNA in your body technically if that primer’s good it might pick that up. And I think that’s the possibility of leading to maybe over treatment. So again, keep in mind that you have to take any lab into consideration with the patient’s symptoms. But I’ve not really been hot on the DNA technology yet. I’m not sure we’re quite at that point where we’ve perfected it, so I’ve been a little hesitant to use those labs.
Dr. Kara Fitzgerald: Armin’s cytokine panel, is it unique enough to implicate Lyme?
Dr. Darin Ingles: Yeah, again, the cytokines are actually relatively specific and I also like Armin because not only can they test for Lyme but they can test for most of the coinfections, too. It’s the same technology. So they call it LE Spot, and again, it’s a cytokine activation test. So again, for someone who’s very early, or even if you’re just concerned about immune activation, you can run Lyme and the whole coinfection panel. Again, I think it’s just a different way of trying to evaluate Lyme and these other tick-borne illnesses.
Dr. Kara Fitzgerald: Yeah, this is very, very useful. And are these all blood tests? Is Armin-
Dr. Darin Ingles: Yeah, these are all blood tests. Some of the other labs can run it off other body fluids, I just think in the reality in clinical practice we’re not doing spinal taps. We’re not doing knee taps and more invasive stuff. But yeah, technically, if you have the capacity to do it that’s great. We know that PCR technology is very specific. If a PCR comes back positive it’s pretty much 100% specific, but the sensitivity is very poor. I used to do a lot of PCR testing and found they pretty much invariably came back negative even when somebody had Lyme. So again, I don’t really do PCR testing anymore just because the yield was very low. But it is available, and if it does come back positive it’s an absolutely. But if it comes back negative, again, doesn’t exclude the possibility.
Dr. Kara Fitzgerald: But again, if somebody’s not symptomatic and we’re going to turn towards what that looks like here in a second, it’s going to impact how you treat regardless of the presence of PCR positivity.
Dr. Darin Ingles: Right.
Dr. Kara Fitzgerald: Okay. So anyway, just to reiterate, folks listening, MDL out of New Jersey, Medical Diagnostics Lab. They’ve actually been around forever. IGeneX, and then Global Lyme Diagnostics. You’re on the advisory board for them, but it sounds like a really interesting test. And then Armin Labs over in Germany. Okay, so let’s talk about symptoms. It’s a clinical diagnosis, as you pointed out the CDC states. What are you looking for? Early and then uncovering some of the more unusual symptoms of chronic presentation. Cover both.
Dr. Darin Ingles: Sure. So acute Lyme disease, you’re generally acutely ill. It’s the high fever. When I had Lyme I had a 105 fever, and I don’t think I ever had a fever when I was a child like that. So I had a 105 fever, headache, usually it’s almost migraine like. Throbbing, pounding headache. You can get swollen lymph nodes, you can get chills, fatigue of course. You can get joint pain, you can get low back pain, you can get neuropathy, particularly in the hands and the feet. It’s almost like a really bad flu.
Dr. Kara Fitzgerald: Yeah, sounds like.
Dr. Darin Ingles: And that often happens within a week to up to a month of that tick bite. What happens though as it starts progressing into more chronic Lyme you’ll see potentially a lot of the same symptoms that you might see in acute Lyme, but often the fever goes away. You don’t feel quite as acutely ill, but we see more neurological stuff. So people will complain of brain fog, memory problems, cognitive impairment. People complain about coordination issues, balance issues. “I trip frequently, I drop things. I feel clumsy.” The neuropathy often gets worse. You’ll get it not just in the hands and the feet but systemically. You can get of course that persistent debilitating fatigue that often amplifies and gets worse. The two things that are really tell tale to Lyme, of course the bull’s eye rash. There’s nothing else out there that we know of that causes that bull’s eye rash. But people need to also be aware that Lyme causes other rashes that are not bull’s eye rashes. And if you go on the internet and look on all the different manifestations of Lyme rashes they’re not all that typical bull’s eye rash.
I had the bull’s eye rash. I had pictures and I lost them on my phone, but it was a perfect textbook bull’s eye. But I’ve seen other, this sort of general erythematous rashes. The big thing with these rashes, though, is that they’re generally not itchy, they’re not raised. Again, most people, unless they see it, wouldn’t even know it was there. So that’s one, because when it’s dermatitis, eczema, usually it’s itchy, it’s flaky. Psoriasis of course it’s raised. Most of these other skin lesions have some other characteristic that kind of helps identify it, but these Lyme rashes tend to be flat and red and kind of really, again, you wouldn’t necessarily know it was there unless you saw it. So when you see that target bull’s eye rash you know it’s Lyme. There’s nothing else that causes it.
The other symptom that’s very unique to Lyme is that migratory joint pain. If it’s any kind of other autoimmune problem, lupus, rheumatoid arthritis, it tends to be the same joints all the time. And when it’s one day it’s my right shoulder, the next day it’s my left knee, the next day it’s my right ankle, again, there’s no other condition that we know causes that. And that’s pretty much unique to Lyme. We don’t even see necessarily that migratory joint pain in coinfection. So when I hear about the migratory joint pain that always makes me think of Lyme. And really, just anybody who’s had chronic both arthritic and neurological issues that have gone on for weeks, months, years that always raises a red flag for me for Lyme or coinfection because again, that combination of the two, there really aren’t a lot of other syndromes out there that cause both neurological and arthritic problems. So when you hear about people who have had these brain issues, coordination issues, and they constantly feel body pain it should at least be at the top of your list to rule it out.
Dr. Kara Fitzgerald: And what about, let me just circle back. You mentioned coinfections, I know we don’t have time to go into detail, but are you using the same suite of different labs to evaluate for coinfection?
Dr. Darin Ingles: Yes, absolutely.
Dr. Kara Fitzgerald: Okay. And do they all offer coinfection testing?
Dr. Darin Ingles: Yes, yes, they do.
Dr. Kara Fitzgerald: Okay. And are you … How are you doing, do you have an intake, do you have Lyme and coninfection intakes in practice or are you just moving through what you know, what you’ve seen over the years and understand to be-
Dr. Darin Ingles: Yeah, obviously part of our intake is like most naturopaths, it’s very comprehensive head to toe. But I also created a questionnaire that’s in my book that I have people fill out. The questionnaire kind of just takes you through a series of symptoms and we rate it, and then based on your score that gives us a pretty good indication about whether you might have Lyme or might have had exposure. So again, in conjunction with laboratory testing, this is just another tool that anybody can use in their practice, and certainly for any practitioner who’s interested I’m happy to share that tool with you. But it’s just a very simple series of about 20, 25 symptoms and they just score it. And then based on that score that can give you a pretty good indication about whether they’ve got some sort of tick-borne illness.
Dr. Kara Fitzgerald: Okay, all right. Great. You can send us a PDF and we’ll put it on our show notes for your podcast, or if you want to send me a link where clinicians can access it on your site that would be terrific.
Dr. Darin Ingles: Sure.
Dr. Kara Fitzgerald: Out of curiosity, what do you think of the Horowitz questionnaire? I know it’s pretty involved.
Dr. Darin Ingles: Well, he’s validated his questionnaire and researched, and again, what I looked at is that it’s very long. When I created my own questionnaire obviously there’s a lot of overlap because Lyme symptoms overlap, so I really looked at the things that I felt were more specific to Lyme. So mine is probably about half of the number of questions as Dr. Horowitz’s. Again, I think the concept is the same it’s that we’re just trying to use different clinical symptoms as a measurement of what your risk has been, or what you exposure may have been. So it’s kind of along the same vein, it’s just a little shorter.
Dr. Kara Fitzgerald: So you talk about Lyme as being an autoimmune disease. It’s obviously got a very clear infection trigger, as do coinfections, but it can turn on autoimmunity. Talk about that.
Dr. Darin Ingles: When you look in the research we know that Lyme can actually trigger various auto antibodies that target the brain, target connective tissue, actually even target your own immune system. Again, this is not really fringe medicine, it’s pretty well validated in the research. And clinically, when we see people with chronic Lyme when you first see them walk in the door your initial thinking is probably going to be, “Wow, this looks like an autoimmune patient.” They sound like someone who might have lupus or rheumatoid arthritis, and honestly I think a lot of these diagnoses are, in at least some cases, tied into Lyme. If you go to the rheumatologist and say, “Okay, well, your patient has lupus. Why?” They’re going to shrug their shoulders, they don’t have a clue. So is it possible that Lyme is a catalyst for some of these autoimmune problems? And I think there’s pretty good evidence that for some people, yes. In my clinic MS is Lyme until proven otherwise. Almost every MS patient I’ve ever treated when we test them they test positive for Lyme and when you treat their Lyme their MS gets better.
My own case, my Lyme turned into MS. But if you talk to a radiologist and you look at an MRI the lesions you see with Lyme are identical to the lesions you see with MS. So what is MS? It’s a demyelination of the brain. What causes it? They don’t really know. So I think it makes sense at least in some people Lyme may be that trigger. And knowing what we know about this ability to make antibodies, particularly to the brain, it makes a lot of sense that that mechanism may be triggering the demyelinating process. So any of these autoimmune diseases, again, when somebody walks in my door the first thing I look at is some sort of tick-borne infection.
Dr. Kara Fitzgerald: What about antibodies? Would you be looking at an antibody panel typical for the condition they’re presenting with, or are there any unique antibodies that you might be looking at or particularly flag for as being more associated with Lyme?
Dr. Darin Ingles: Yeah, unfortunately the antibodies that we’ve identified in research, there is no clinical commercial test available for those specific antibodies. I see a lot of people with Lyme that might have a low titer A&A, which of course is a very nonspecific test. So the type of antibodies that are probably being produced, I don’t know that we have a commercial test available to measure that, but I still do look. I’ll use some of the Cyrex testing to look at their autoimmune profile, particularly the ones that have the neurological antibodies, things like myelin and synapsin and so forth. So I think there is some value in trying to evaluate autoimmunity to the brain particually when there’s a lot of neurologic symptoms present. But when you look at the research on the antibodies that Lyme triggers these are not the same antibodies, so I’m hoping at some point, some researcher will develop a test that can actually start measuring some of these antibodies. Because again, we have identified them in the literature, but we just don’t have a commercial test available yet.
Dr. Kara Fitzgerald: Yeah, and now that you’re on a board over at a laboratory.
Dr. Darin Ingles: Yeah, you know what, it’s funny. I mentioned that to the owner and I think he looked at the research, he says, “That sounds very complicated.” I’m like, “If you guys figure it out then I’m hoping that …” Of course with all these lab tests you’ve got to have someone who makes the reagents and the test kit, unless there’s a test kit available. Most labs themselves don’t make the test kits, they buy it from somebody else. So you probably got to get a drug company out there to make the test kit first and then the lab can start offering it. So fingers crossed, maybe one day we’ll evolve to that point where we can really do that kind of testing because you can imagine how valuable that would be. Because not only would we have a way of measuring that autoimmune response, but we’d also have a way of monitoring treatment to see if we’re able to down regulate that response.
Dr. Kara Fitzgerald: Is the Cyrex panel pretty useful for that purpose, even though it’s less specific would you say? Is it fairly-
Dr. Darin Ingles: You know…
Dr. Kara Fitzgerald: Yeah, go ahead.
Dr. Darin Ingles: It is correlated with what I’m seeing clinically.
Dr. Kara Fitzgerald: It is?
Dr. Darin Ingles: So from that standpoint I see value. And again, I’ve had patients where we do their initial testing, we saw some evidence of autoimmunity to particular, specific brain proteins, and then after however many weeks or months of treatment we’ll repeat it and sometimes we’ll see these antibody levels go down or even go away. So even though it’s nonspecific I think it’s giving us an overall picture about neural inflammation and that disposition towards autoimmunity to neurological tissues. So I think from that standpoint it’s helpful.
Dr. Kara Fitzgerald: Good, good. And Dr. Vojdani might dive into it and take your idea and look at it. That would be pretty cool if they did over there.
Dr. Darin Ingles: Yeah.
Dr. Kara Fitzgerald: All right, listen, one more question on background and then we’re going to spend the rest of the time on treatment. You talk about mycotoxicity mimicking Lyme and just the vulnerability there in folks that are mycotoxic, or have Lyme Disease and go on to develop mycotoxicity more readily. Can you just talk about that?
Dr. Darin Ingles: Yeah. When you write down the symptoms of Lyme and write down the symptoms of mycotoxicity there’s a tremendous amount of overlap, and almost identical. And I’ve seen a lot of people who after they’ve had exposure to Lyme seem to be more sensitive to mold. And I don’t really know what that mechanism is, I haven’t read anything that tells me why. I don’t know if it’s necessarily a disruption in the immune system that disposes towards that. With mold, there’s mycotoxicity but there’s also mold allergy. They’re two different issues but clinically can cause similar symptoms. Rich Shoemaker of course, who’s been the big mycotoxin guy for a while, I will respectfully disagree that mycotoxicity is the bulk of the problem for mold. Only in that mycotoxicity is usually tied in to some element of water damage. So if you have a leaky roof, leaky basement, leaky pipe, that kind of thing. Yet mold allergy is extremely common because mold spores are in most of the country. So I find in my practice that mycotoxicity certainly for someone who’s been exposed to a water damaged building can be significant. And again, for any Lyme patient who’s had these symptoms, particularly if they haven’t responded well to Lyme treatment.
I usually evaluate for mold very early in our process just because it’s just so common to do a urine mycotoxin test to at least rule it out as a possibility. It’s very simple. And actually, Great Plains Labs now has a new mycotoxin test. It actually isn’t that new, I think it’s been out now for a couple of years, but we’ve been using that and find it very useful as evaluating potential exposure to mycotoxicity. But part of that is you may want to go through and do some element of testing for mold spores or mold sensitivity, just because again, that can also cause brain fog, and joint pain, and fatigue, and mood changes. So it’s not all mycotoxicity, sometimes it’s mold allergy. But doing that mold workup as a whole I think is an important part for any Lyme patient just because the overlap is extremely common. Most Lyme patients do have mold issues, and if you live in a part of the country where there’s a lot of moisture it’s just around you. So just to expedite your process with patients, trying to deal with both at the same time just makes things go a little faster.
Dr. Kara Fitzgerald: Yeah, absolutely. I agree. And then for working up for allergic disease, I think you’re doing skin testing in your clinic, but I routinely use immunoCap through any standard reference lab. Comments on that, just working up the mold allergy patient?
Dr. Darin Ingles: The only thing, immunoCap’s fine, it’s an IgE test, but a lot of mold allergy has nothing to do with IgE. So again, the only problem you’re going to run into is that if your IgE comes back negative, again, it doesn’t exclude the possibility of still having mold allergy. And I run it on patients and it comes back kind of negative, yet they tell me every time it rains, every time its humid, every time they go into a damp basement they get a headache and feel tired. We can see that they’re having a reaction to mold even though their IgE was negative. So skin testing tends to be more accurate. Actually we’ll look at delayed reactions, not just the acute reactions. So we’ll measure 24-48 hours after doing testing for any kind of late, delayed reaction.
Dr. Kara Fitzgerald: Okay. So you recommend specifically skin testing?
Dr. Darin Ingles: Yeah. And if you don’t do it in your clinic find an environmental medicine doctor that does it. There’s plenty of us around the country who do it and you can refer your patient out just to have that part done and just find out if that’s part of the problem.
Dr. Kara Fitzgerald: And you’re doing intradermal I’m assuming?
Dr. Darin Ingles: We do a combination. We do intradermal, we do skin patch, and we actually even do some esoteric kind of testing. So it’s just a combination to try and cast as wide a net as possible. Skin patch testing is another great way and it’s very easy for people who don’t want to get into doing intradermal testing. If you’ve got prescriptive authority at least as a naturopath you can get the extracts from an allergy company and really as you put the patches on they stay on for 72 hours. They’re not very comfortable, but it is an easy way to measure how the skin’s reacting and it’s been shown to be a valid technique for measuring for allergy. And because it’s on for 72 hours you are going to pick up some of those late, delayed reactions.
Dr. Kara Fitzgerald: Okay, all right. So you can find a local provider who’s doing some of these, doing intradermal and possibly patch if you’re not doing it through your office through the American Academy of Environmental Medicine, and we’ll link to that in the show notes. Okay, so let’s talk about protocols. You specifically are using a modified Cowden protocol, and you’re using the Zhang protocol that originally got you better. Talk about these in detail.
Dr. Darin Ingles: Sure, the Dr. Zhang protocol as I said, that was my first experience with the different herbal protocols out there. What I like about his protocol is that in Chinese medicine, Chinese herbal formulas are always used in combination. They never use herbs singularly as we often do in western herbal medicine. So every formula is put together to be really kind of synergistic. And of course I’m not an expert in Chinese medicine, I can’t really speak to that level, but from what I do know about Chinese medicine and Chinese herbs is that every formula kind of has a purpose and the herbs are put together for very specific reasons. His formulas contain anywhere from three up to I think 12 different herbs in each formula. And what I like about the formula specifically is that they address I think the totality of everything Lyme is doing to your body. So it’s not about just going after the infection, but it’s helping reduce inflammation, and improve circulation, and breaking apart immune complexes, and really dealing with everything else that Lyme is doing to your body. So he’s got a lot of different herbs in his company, but again, I’ve used a handful of them clinically and I find that that’s what most people respond well to.
So for example, one of the formulas, the lead herb is artemisia. And of course we know about artemisinin and its ability as an antimicrobial. And artemisia, not only is it effective against Lyme but it’s very effective against babesia. In fact, they use artemisia to treat malaria in Southeast Asia. So artemisia’s a great herb. And what I like about his herbs is they are actually more concentrated then pretty much every other company I know of that makes herbal medicines. So they go through a specific process of really concentrating it to get high potency out of it. One of his other formulas contains an herb called houttuynia. We don’t really use houttuynia in western medicine, but it’s used a lot in Chinese herbal medicine. Again, it’s a very potent antimicrobial, has effects against actually bacteria, viruses, fungi, parasites. So pretty broad spectrum antimicrobial. He’s got another product called Circulation P, it’s a mix of different Chinese herbs that really help improve circulation. So it’s not a blood thinner, even for people that are on blood thinners they can safely use this formula. It’s not preventing platelet aggregation.
But I don’t know if you’ve noticed in your own clinic, when I draw blood from patients with Lyme I can even tell before doing the test based on the viscosity of the blood, instead of coming out like water it comes out like oil. That high viscosity is usually a sign of inflammation, so that’s a very common thing you’ll see in Lyme patients if you draw blood in your office. So Circulation P is really about improving circulation. He’s got a formula called AI#3, again, I think there’s 10 different herbs in that formula and it’s an anti-inflammatory formula. The only thing with AI#3, I always have to warn women who are premenopausal is that it can interfere with menstrual cycle. So women who are still cycling I do recommend that they go on for three or four months and then take a break. And if they start to experience any kind of change in their menstrual cycle just take them off.
The other formula I use is called R5081. It’s basically a cordyceps formula, so cordyceps can really help with fatigue. Of course it’s a medicinal mushroom, it’s a potent immune booster. So those core five herbs are really kind of part of the protocol. He also has an extract of coptis, coptis is a root. Again, we don’t really use it in western medicine, but it’s a very potent antimicrobial. And coptis is really one of my go-tos for people with acute Lyme disease. Because again, it probably has the broadest antimicrobial effects.
Dr. Kara Fitzgerald: So if someone’s not going to go to doxy or amoxicillin you’re going to use coptis as part of your baseline protocol?
Dr. Darin Ingles: Yeah.
Dr. Kara Fitzgerald: And how do you dose that?
Dr. Darin Ingles: So pretty much all of these capsules are one capsule three times a day for an adult.
Dr. Kara Fitzgerald: Okay. And would you use anything else with that coptis? Just to pin you down.
Dr. Darin Ingles: Yeah, for acute Lyme we use the combination. I use the coptis, I use the houttuynia, and often I’ll use the Circulation P. And then the other ones we kind of add in, if someone really has a lot of joint pain, inflammation, we’ll add in the AI#3. He also has a pueraria formula that we’ll use for people that get brain fog and other sort of neurocognitive impairment. So a lot of the other herbs we add in as needed depending on what the particular symptom picture is. The other formula he has is he has an allicin formula, a garlic extract, and he originally put me on that when I had Lyme. And allicin’s a very potent antimicrobial, but it’s all excreted through your lungs and skin. I smelled like a pizzeria every day and I just couldn’t stand to be next to myself after about two weeks of being on it, so I personally don’t really use the allicin much. But if people can tolerate it it does work really well against Lyme, it’s just you have to warn people they’re going to smell like a pizzeria for a bit.
Dr. Kara Fitzgerald: And now, you have to go directly to his site to be able to access his products and I think there are a few educational hoops one needs to jump through.
Dr. Darin Ingles: Yeah, if you’re a practitioner and you want to set up an account with him it’s just hepahealth.com, and if you just contact the company directly they’re actually out here in Irvine, California. They’ll set up a professional account with you.
Dr. Kara Fitzgerald: Okay, all right. Perfect. Talk about the Cowden protocol, too.
Dr. Darin Ingles: Yeah, so Dr. Cowden, he was a cardiologist in Dallas. I believe he’s retired now, or at least semi-retired. He had kind of gotten into the Lyme world by accident, I think he was treating his nephew who had Lyme. And he’s a cardiologist, so basically his protocol involves using herbs. Almost all these herbs come from South America in the Amazon and they’ve been used by indigenous people forever. And his protocol, if you follow it to the T, is I think a five or six month protocol where every month you keep changing the different herbs. And the concept is basically try to confuse the organism, never let it get to a point where it gets used to the same thing. What I found, though, is that it’s very complicated for patients, gets to be kind of expensive, and a little bit hard to follow. So Dr. Eva Sapi, who’s a researcher at University of New Haven who got Lyme herself, she started researching some of these herbs and found they actually work better than doxycyline, at least in vitro.
So I’ve really kind of stuck to what I call a modified Cowden, where I really only use four of his tinctures consistently. Sometimes we’ll add in one here or there, but there’s a combination of samento, which is a cat’s claw extract, and again cat’s claw is a very potent antimicrobial. Also a very potent anti-inflammatory. There’s one called banderol, and the other one’s cumanda. So banderol and cumanda both come from the bark of a tree that grows down in the Amazon. And again, they’re both potent antimicrobials, anti-inflammatory, but banderol and cumanda also have a little bit of analgesic effect. So it’s also great for people that are experiencing pain. And the fourth tincture is burbur. Burbur is a bush that grows down there, and it’s really about detox. Burbur itself doesn’t do anything against Lyme, but burbur is a great way of also helping mitigate some of these herxheimer reactions that people experience when they’re going through any Lyme treatment. Burbur is one that I have people take routinely, but if they start to get that die-off reaction they can take it every 30 to 60 minutes as needed if they feel that herxing coming on. And in many cases it really blunts it. The burbur is really just there for detox.
Dr. Kara Fitzgerald: Perfect. And so these are the two workhorse protocols that you’re using in addition to some of the immunotherapy that you talked about earlier, is that correct?
Dr. Darin Ingles: Yeah, these are the two protocols I’ve used most. And the reason I like them is that, A. clinically they work well for a lot of people and B. these herxheimer reactions are less common on these protocols than they are on some of the other herbal protocols out there. There’s a lot of great herbs out there and I’ve got nothing bad to say about any of them, they’re just different. Byron White’s got some herbs, and Susan McCamish with Beyond Balance has some great herbs. Stephen Buner has his whole protocol. And when you look at what the herbs are doing mechanistically they’re kind of the same. They’re still antimicrobial, they’re anti-inflammatory, it’s just that I found with some of these other herbal protocols herxing is more common. People usually feel pretty bad when they’re on those protocols. Having gone through Lyme treatment myself I’d like to get people feeling better without necessarily having to feel a lot worse. So I don’t think it’s necessarily a case where you have to get a herx reaction. I know some practitioners feel like if you’re not herxing you’re not really doing anything, and I disagree. I never, ever herx. Any protocol I was ever on, even when I was on antibiotics. So I don’t think it’s true at all that you have to herx to have a clinical response. But again, if I can get people feeling better without necessarily making them worse that would be my preference.
Dr. Kara Fitzgerald: So this has been such a great conversation. I’m going to ping you with some extremely important questions here now that we’re at the end. But we have to talk about diet. You’re using an alkalinizing protocol with your patients and you think that’s best, so we need to talk about that. And then we have to talk about the all important lifestyle factors. Fundamental to your own healing journey was a pretty radical about face in how you approached life. And I get that as essential, so let’s just address that. The diet you’re prescribing for your patients and the really key … Well, and actually, you also threw in gut. I just want to say, sometimes we mention these at the end, kind of throw them in, and I’m guilty of doing that right now. But the fact is, they’re absolutely foundational and fundamental to wellness. Healing the gut, getting people on a clean diet, and investigating their lifestyle habits and switching those around as needed. So go ahead, Darin. Talk to me about what you’re doing there.
Dr. Darin Ingles: The gut accounts for up to 80% of your immune function, so if your gut’s not functioning well then obviously your immune systems not going to function well. And of course with all the massive amount of research coming out on how important the microbiome is for just about pretty much everything it’s not just about your immune system, it’s about your mood, and your weight, and everything else. The more we disrupt that the harder it is to heal and get well. So I think most people listening are probably pretty savvy on various ways of healing the gut, treating leaky gut and so forth, but from a diet perspective, after having tried various diets, I know right now keto is kind of the popular kid-
Dr. Kara Fitzgerald: The darling, yeah.
Dr. Darin Ingles: What I found is that with Lyme patients, because there’s so many issues of fatigue, and just trying to eat well is extremely difficult. And so I was trying to find something that of course, A. clinically helped people but, B. was really sustainable. I think when we say diet we always think about something that’s a short term thing to accomplish a specific goal. And what this is really designed to be is something that people … It becomes a lifestyle change. It becomes just a normal way that they eat. And there was a whole bunch of stuff written long before I ever went into naturopathic medicine about alkaline diet, and it was surprising, when I dug into the research there’s actually hardly any research out there at all on an alkaline diet. I was shocked. I think I came across three studies, it wasn’t very much. Now, granted, in those three studies they were all very positive. But it makes a lot of sense to me chemically because physiologically when you look at how cells function they really function best in an alkaline PH, with the exception of the stomach, the bladder, and for women, the vaginal area, which are very acidic to protect against outside invaders. The rest of our bodies is actually very alkaline.
So I think when you look at a Paleo diet the big difference between an alkaline diet and Paleo is that I think the consumption of animal protein in Paleo tends to be a lot higher than it should be. And I think if we go back to our true hunter gatherer days we were mostly vegetarian. We didn’t kill every day, we killed when we could. So we ate animal protein, but it really wasn’t the bulk of our diet. So what an alkaline diet really is about is it’s about mostly plant based diet and we try and limit animal protein to less than 20% of your dietary intake for the week. And then there’s certain foods we say, “Look, these are very acid forming in the body. Let’s just eliminate them completely.” So that’s dairy products, it’s junk food, it’s coffee, it’s black tea, it’s honey. Some of these foods which we really like are really acid forming in the body. So at least initially I advise patients, I’m like, “Look, at least toe the line, let’s be as diligent as we can.” I know for myself I used to love coffee, and I would take a sip of coffee and my neuropathy would flare up within minutes. So even a little bit for some people can be too much.
Now I’m at a point now, having been off coffee for three plus years, I can have some every now and then and I feel fine. It doesn’t bother me anymore. So it’s not like people have to be that rigid their whole life, but at least initially it’s a good idea to follow the process. So I’ve got an outline in my book of what that looks like more specifically if people are interested, and actually I work with a nutritionist who actually created a whole month meal plan for people who want to follow an alkaline diet. It’s called prepdish.com, and her name is Allison Schaaf. She’s a very talented nutritionist and she put together a bunch of great recipes. It’s a great resource for people who want to recommend this kind of diet as a way of helping initiate what should I be eating, how to eat. And again, what I find is that it’s a diet that people can follow. They don’t really feel deprived, they can still eat their steak, they can still eat all the things they love pretty much. Dairy, fortunately, there’s a lot of easy dairy substitutes. The one I get a pushback on all the time is coffee. I think most Lyme patients are so tired, they’re so fatigued, coffee is what gives them that adrenal kick. So we try and transition them over to green tea and other herbal teas and things of that nature.
Diet is always hard, and when you feel tired and you don’t feel well it can be challenging, but I just see so many people clinically feel a lot better when they start eating healthier, eating this way. But again, it’s something they can really sustain their whole life.
Dr. Kara Fitzgerald: And just say something about the lifestyle piece.
Dr. Darin Ingles: Well, it’s the one part I think we as practitioners probably forget about perhaps the most. I think we get so focused on the physical aspect of Lyme we kind of forget about all this other stuff that’s really important to feeling well and healing. And sleep is really I think one of the biggest problems. I see so many Lyme patients used to sleep well and after Lyme now they don’t sleep well at all. And it’s difficulty falling asleep and staying asleep, and they wake in the night. You need that deep, restorative sleep to heal your brain. That’s when your neurons repair themselves. So all that tissue repair happens in our deep sleep. So the more we miss of it, the harder it is for your body to heal.
Dr. Kara Fitzgerald: And how are you supporting people achieving that deeper sleep?
Dr. Darin Ingles: So it’s a combination of being mindful of getting off the electronics before bedtime. Again, we’ve got good research now how iPads and iPhones are goofing up your sleep cycle, so people need to get off the electronics. I have people turn their wi-fi off at night. I think some people become very sensitive to electromagnetic radiation. But there’s also a lot of nutritional things we can do to help facilitate better sleep. People need to understand that sleep is a pattern and you’ve got to train your body to that pattern. So I advise people, go to bed at the same time every night, whether it’s the weekend or not. Try and stay on the same routine. And if you’ve had disrupted sleep for long periods of time it can take a while before your body resets itself. But we can use nutrients like 5HTP and melatonin, and glycine, and I use a lot of CBD oil now. I find that very beneficial for people and helping them get deeper sleep. So we’ve got a lot of really great nutritional things in our repertoire to help people achieve deeper, better sleep.
Dr. Kara Fitzgerald: Okay, good. What CBD oil are you using?
Dr. Darin Ingles: I use the one from Cannavest. I like Cannavest, they have basically an organic farm in Holland where they grow their plants and a lot of the research that’s done on CBD oil is their product. So I like the fact that the research has been done using their specific product. And they make a liquid and capsule, so I like the fact too that every batch is pretty much the same. Everyone and their brother now has a CBD product, so depending on who you get it from a lot of these companies they kind of just crush up the whole either hemp plant or cannabis plant and they don’t really standardize it so that every batch is a different dose. With Cannavest they treat it like a drug. Every batch is delivering the same amount of CBD, so I think there’s just more consistency from batch to batch.
Dr. Kara Fitzgerald: Well, Dr. Ingels, we’ve gone kind of way over time here, but this has just been a great, great, great conversation and I could continue to pick your brain on it, but we’ll just have to circle back and do a part two at some point. You’ve just been a huge wealth of resources, and I know people have been taking a lot of notes. And folks, we will gather as many of the pearls from his podcast and print them in the show notes for easy access. We’ll try to link to some of the companies he’s mentioned and just corral all of these pearls together for you. All right, Darin, I’m so glad you’ve released this book. It’s useful, it’s nicely written. You’ve got superscripts in there, it’s well referenced, and you’ve just done a great job in this field. Thank you.
Dr. Darin Ingles: Oh, thank you, Kara.
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