Is It Mold Or Lyme? The Lyme-Mold Connection

Ann Shippy, MD

Welcome to another episode of Mold, Mycotoxin, and Chronic Illness. I am your host, Dr. Ann Shippy, and today we get to talk with Dr. Nafysa Parpia. She is board-certified in naturopathic medicine, and she specializes in the topic that we are covering, which is chronic illness, which ranges from tick-borne illness to mold and micro-toxin illness, autoimmunity, and fibromyalgia. Chronic long-haul COVID and chronic fatigue: She is heavily involved in the organizations ISEAI and NeuroHacker. Today we are going to delve into the mold-lyme connection, which is so important. Thank you so much for joining us.

Nafysa Parpia, ND

Thank you so much for having me.

Ann Shippy, MD

Did I leave out anything important? Is there anything else for the audience to know about you before we dig in?

Nafysa Parpia, ND

No. You covered it. Great!

Ann Shippy, MD

I am just delighted to have you here today. Let us dig into what Lyme and mold have in common. When we have patients with chronic or severe illnesses, why do we need to consider them both?

Nafysa Parpia, ND

Many people have. I might start by telling our audience what Lyme is because some people listening might not know what chronic Lyme is. Lyme disease is caused by a bacteria called Borrelia burgdorferi, which you can get from the bite of an infected tick if it is treated within the first 4 to 6 weeks. Usually, most people are cured now when symptoms persist for more than 4 to 6 months, whether it is six months post-treatment or they have had no treatment at all. Then it is called chronic Lyme. The classic symptoms are very similar to the classic symptoms of mold illness and mycotoxin illness. We will dive deep into that as we talk about them.

Ann Shippy, MD

I would love for you to talk about the most common symptoms that you see in patients with Lyme or tick-borne illnesses as well. Even how you might think about some of the different ones, and yes, how you start that process of distinguishing whether you need to consider one or the other or both,

Nafysa Parpia, ND

Okay. The classic symptoms of tick-borne diseases are joint pain, muscle pain, neuropathy, nervous system dysregulation, brain fog, GI issues, hormonal imbalances, and chronic fatigue. The different tick-borne diseases are also going to have different symptomatologies. For example, joint pain, neuropathy that is very much Bartonella-icepick pain, headaches, radiating nerve pain, and diffuse muscle pain are more like Lyme. Now, the nervous system dysregulation that this adenoma can come from anything that I would say is tickborne-related or related to mold—the brain fog, the GI issues, the hormonal imbalances, the fatigue—is the same thing. 

But the thing about chronic Lyme is, as we call it, that when it is clear from the lab testing and/or history that these co-infections are present, the Lyme in the co-infections is active. But once it is a chronic illness, all of the symptoms of various diagnoses start to mimic each other. Tick-borne diseases, mold, mycotoxins, illness, COVID long-haul, parasites, and environmental toxins. When it is a chronic illness with many diffuse symptoms, all of these occur at the same time in one person. It is never just one bug; it is never just one toxin, mycotoxins, for example. It is a multi-causal, multi-systemic, and multi-symptomatic illness. Then it becomes hard to piece it out. Is it Lyme? Is it acting out? Is it a mold that is acting out? At some point?

Ann Shippy, MD

Or both.

Nafysa Parpia, ND

Those are all, and there is the interplay. All of these are causing immune dysregulation, and that immune dysregulation causes more inflammation in the system. At some point, the body does not. The body is more of an ecological model. For example, in a salad, we can say there is a tomato, there is a cucumber, and there is lettuce, but the body sees it more as a soup. We try to distinguish that it is more linear because that is how our minds are. Human minds need to think about it in some way, but at some point it becomes inflammation.

Ann Shippy, MD

I love the way that you just put that together with the body. It is soup because it is what is in the cellular materials and what is in the liquid materials. The lymph, the blood, and all of the liquid. It is a soup floating around. It is because our bodies are so amazing. It can be aware of all of those things at the same time and be very careful trying to regulate what it needs to do to get things back to homeostasis.

Nafysa Parpia, ND

Yes. It is an important concept for people to understand. Is chronic Lyme or mycotoxin an illness? It is not just about the Lyme or the mold. It is not just about both of them. It is about the person and how they are specifically affected by a variety of issues causing immune dysregulation and inflammation. It is a highly personal process when it comes to a point when the patient has multi-systemic symptoms.

Ann Shippy, MD

It will. Just back to your first description of the Lyme and the timing of things. Do you ever see people? I think I have seen a few that had no awareness that they had actually even had a tick bite, or if they have not had a tick bite, do you just rule it out?

Nafysa Parpia, ND

A large majority of my patients have no idea that they have ever had a tick bite. It could happen. It could have happened when they were two years old, for example. no idea.  Their immune system was able to keep it in check; I just think the immune system should be able to keep it in check. But then they had other things happen, which I would love to talk about. Why? Why is it that somebody has no idea they have a tick bite, but then all of a sudden they are in chronic Lyme?

Ann Shippy, MD

Let us go for it. This is so important.

Nafysa Parpia, ND

I’ll say this: Almost everybody who walks through my doors has various other low-grade infections, including co-infections of Lyme. That could be Bartonella. But these are Ehrlichia tick-borne relapsing fevers, for example, viruses, parasites, mold, and bacteria—they’ve got all of this going on at the same time. It is chronic—not talking about acute illnesses, but chronic. There is this interplay between these various chronic infections. For example, babesia can suppress the immune system’s ability to clear intestinal parasites. Very often, we find intestinal parasites in our patients—parasites, sequester funguses, and metals. We have to think about all of these. At the same time. We have to consider all of these chronic infections. 

Then there are various locations of microbial colonization: the gut, sinuses, teeth, and even the jaw. We need to think about environmental toxins, various toxins, mycotoxins, metals, microplastics, glyphosate, and pesticides. It is the spike protein, so it is important to consider their genes as well. I often see snippets in their genes of detoxification and their inflammatory pathways. They often have structure and integrity issues, lax ligaments, or tight fascia. When there is inflammation in the body from all of these various reasons, the inflammation is going to land in the areas where there are structure, integrity issues, and stress. At this point, they are very stressed out because they are sick.

Ann Shippy, MD

In this area, stress is such an important factor.

Nafysa Parpia, ND

Then all of these together cause immune dysregulation, inflammation, and cellular stress in the nervous system. There is an art to it that is a skill set, just piecing it out using the appropriate tests. You alluded to this earlier; how do we piece out what it is with the patient?

Ann Shippy, MD

That is the art of medicine, which depends on the budget. These tests can be so expensive, and I can imagine the people listening might feel a little overwhelmed by all those possibilities about what is gotten in there. I would love for you to know that you are very thoughtful about how you work with each patient, and you probably have a little bit of a different approach with each patient, depending on the clues that you get from their detailed history. But I think this is just a beautiful approach to this. I know your patients are so lucky to get your particular heart and mind based on their feelings.

Nafysa Parpia, ND

Yes.

Ann Shippy, MD

I would love to hear some general principles for how you make those big decisions on where you start with the workup and then the most important things that you should include, and even talk about the testing companies. It is all, I think. I think that is an important piece of sharing, even with which companies you have gotten the most reliable results from.

Nafysa Parpia, ND

Sure.  I am casting a wide net concerning infections and toxins. The reason I am doing that is because, if somebody is well, I have seen 95% of my patients who come to me as chronically ill, and they have these diffuse symptoms throughout almost every system of their body. Now, how do we piece that out? Usually, it is a combination of many infections, and they are chronic. They are often low-grade toxins and then SNPS and their genes of detoxification, structure, and integrity issues. There are so many different layers to this. I am casting a wide net on the infections because I do not know what infection it is. I can get a hint that it is a tick-borne disease. When the patients are talking about pain, there is a lot of pain in the joints, in the muscles, and the bones, even if they do not.

Ann Shippy, MD

Play that the immune system is trying to regulate but creating so much inflammation. Then I think of it as just settling in where there has been some wear and tear.

Nafysa Parpia, ND

Right. Which is where the structure integrity piece comes in. However, I would test with two different tests for tick-borne diseases. I use IGeneX, and I also use Infectolab. With IGeneX, we can now do a culture, a PCR test, and look at antibodies. We have a sense of if the patient has had the infection in the past or if they are if they do currently have it; if it is, if it is in the blood or cultured out, we know it is there now.

Ann Shippy, MD

Which of those are you finding? Where do you start? Which one of those are you finding most reliable, especially if you are suspicious that there is going to be a tick-borne?

Nafysa Parpia, ND

If I am suspicious that this patient is having this infection right here, right now, I am very interested in looking at their T cells, in which case I am going to use an Infectolab. Yes.  interferon gamma, and interleukin 2. If interferon gamma lights up, it means this patient is fighting it right here, right now. If interleukin 2 lights up, it means they have recently seen the infection. They are not fighting it right now, but there is still some inflammation left. Now, some people cannot mount and appropriate their T cells.

Ann Shippy, MD

They cannot mount their immune response.

Nafysa Parpia, ND

It is very often that when I have done both tests, I have had to rely on both. I said, Okay, your Infectolab shot is not showing, but you have got this happening. Let us take a look at IGeneX because I am highly suspicious of the symptoms. They are screaming to me that this is a tick-borne illness. Then we use IGeneX, and the antibodies show, and I can say, All right, look, we can see that you have had this infection in the past, or maybe we can even see they have it now. This other part of your immune system, which is making the antibodies, is showing that this is here in your body, or now the culture. I have not done the culture yet. Yet. It is so new, but I am looking forward to using that as well.

Ann Shippy, MD

I was hoping that you had because I have not yet either.

Nafysa Parpia, ND

Yes. I want to use those two tests for testing.

Ann Shippy, MD

Do you ever use the T-Lab?

Nafysa Parpia, ND

No, I usually use Infectolab, and I generally

Ann Shippy, MD

You need between those two. Okay. I like the strategy. You do the Infectolab if you get the TNF alpha and the

Nafysa Parpia, ND

And the interleukin.

Ann Shippy, MD

You look into it, and then that is enough. You can stop there. If you do not, then you move on to

Nafysa Parpia, ND

Right. Because sometimes, if we provoke with an IV, we do not need to give our patients IV antibiotics. If Lyme is neurologic, and I strongly suspect it, we might provoke it with an IV antibiotic. Then, one week later, we tested in Infectolab to see if there was a bump up because of that antibiotic and could get the immune system to start doing its job. It is very often that we do that as well, just to double-check.

Ann Shippy, MD

Okay. I do this. You have a great strategy to make sure that you do not miss it. That is the problem; it is most of the time missed.

Nafysa Parpia, ND

Yes, very often. Then I will look at what other infections there are. With Lyme, there are co-infections. These are infections. This is for our audience, who might not know there are infections that one can get, but when one gets bit by a tick, they are infectious. That tick can transmit to the person Lyme Bartonella and Ehrlichia; these are tick-borne relapsing fevers. These are the co-infections of Lyme that are so common that people have concurrent infections. These are infections that these patients are more susceptible to. When people have tick-borne disease, their immune system becomes so dysregulated that it becomes more permissive to other concurrent infections. I am looking for the herpes family of viruses. Epstein-Barr virus, cytomegalovirus, HSV six, age 67, HSV one and two, and, very commonly, these patients have chlamydia, pneumonia, and mycoplasma pneumonia. These I can just look at on LabCorp.

If the patient wants to spend the money, we can go to Infectolab, where they are going to look at the T cells. But looking at the antibodies gives me a sense. But I also tell my patients, look, when I am looking at the antibodies for viruses, I cannot say for sure that you have this virus currently or not because viruses insert pieces of themselves into our cells. That is normal. It is not replicating a virus. It is what happens to us daily. Our immune systems should be able to walk by that and not care. A lot of times, people start to mount immune responses to pieces of virus that are not active. The patients have this hyperactive immune response. When I am looking at the antibodies to these viruses in lab work, if they are high, I think that the patient probably has a hyperactive immune response to pieces of the virus. We can verify in Infectolab if these viruses are indeed active in the patient.

Ann Shippy, MD

What I see sometimes in my patients is that, especially when their toxic load has gotten high, they are probably really like dirty soup. A lot of these responses are upregulated. Is that what you are seeing too?

Nafysa Parpia, ND

100%. The next thing I am doing is testing the environmental toxins. Of course, I used to use the Great Plains.

Ann Shippy, MD

I know, so sad.

Nafysa Parpia, ND

Then I thought, All right, I am going to use Mosaic because Great Plains turns to Mosaic. But that is what happened. What I am using now is IGL. Have you been using IGL?

Ann Shippy, MD

I love IDL. Yes, it is my favorite, but the whole shipping issue is a little tricky, and we have to figure out how to work around it because it is for the listeners; you have to send blood to Germany. Which is what? We need to get one here.

Nafysa Parpia, ND

Let’s make it. Yes.

Ann Shippy, MD

Two or three times the expense, but

Nafysa Parpia, ND

But yes. Yes, but anyway, yes.

Ann Shippy, MD

Here is why we love IGL.

Nafysa Parpia, ND

We can look at various environmental toxins. We can also look at different fungi and metals. We are getting a very good idea of what environmental toxins can be stuck on the membranes of our cells. Most environmental toxins can get by. They accumulate in our fat cells’ memories. We can tell that from the IG-out test. Now, there is a lot of research out there that talks about how environmental toxicity can cause immune dysregulation. Our patients have a hyperactive immune system and a weak immune system. At the same time, we are seeing hyperactivity, meaning we’re seeing autoimmunity; we are seeing massive activation syndrome; we are seeing this hyperresponsiveness to pieces of virus when it is not replicating. The immune system is hyperactive, and simultaneously, the immune system is weak. They cannot mount the appropriate immune response to kill all of these chronic infections. I want to bring it up.

Ann Shippy, MD

When these infections are having a party, they are just living it up.

Nafysa Parpia, ND

They are because they have these toxins; they are causing inflammation, and the bugs are causing inflammation. The toxins make us more permissive to these infections. I also test for metals using doctors’ data. As a person, I am doing this testing for myself.

Ann Shippy, MD

I know how similar these things were.

Nafysa Parpia, ND

That is great.

Ann Shippy, MD

Yes. You talk about how you will do the metal testing.

Nafysa Parpia, ND

I am testing first, just using blood and urine in the standard lab work. I want to understand if there is an acute exposure. If there is an acute exposure, then I want to stop that exposure before I begin to even start the detoxification therapies, because I could do chelation therapy or detoxification therapy until the cows come home. But if there is an acute exposure, it is a waste of the patient’s time and money. We’ve got to rule that out.

Ann Shippy, MD

Talk about the most common causes of acute metal exposure that you are seeing.

Nafysa Parpia, ND

Lead. I am seeing a lot of lead in women too.

Ann Shippy, MD

This is awesome. Yes. We have not seen that it is happening, but it is awesome that we are finding it.

Nafysa Parpia, ND

Yes. The bones are a repository for lead. Homes built before 1978 had lead pipes or paint. Even though it has been banned from use now, it does not biodegrade. It is still in the environment. Our bones are a repository for lead and other metals, but mostly for lead. Those of us who were born before 1978 had higher exposure to lead, for sure. It accumulates in the bones. When it is in the bone, it is not pretty stable. But then, when women hit menopause, when we start to lose some bone, we get bone turnover, and we can become our internal source of exposure to lead. When I find lead in my patients, it is not only women; it is men too. Men can have osteoporosis as well. But I think that people forget about that. When someone is over 50 and I see a high lead, I am thinking about that for sure. I want to do a DEXA scan to understand if they have osteoporosis, and if they do have osteopenia or osteoporosis, I want to put a stop to that bone loss before I start to treat the metals lightly.

Ann Shippy, MD

Otherwise, it will just keep worsening.

Nafysa Parpia, ND

Exactly. I ask people to test their drinking water. Mytapscore.com is a great test. I want to have people test their water, even their filtered water. It looks at all kinds of metals and even other toxins as well. It is very often that I find that my patients’ water has lead in it.

Ann Shippy, MD

It is a good resource. Mytapscore.com 

Nafysa Parpia, ND

Yes. The patient just wonders themselves by having them test their filtered water and non-filtered water. We found arsenic in the well water. That is very common. It is very often that my patients have mercury; it is very often that they have mercury amalgams, and those amalgams are leaching or they do not have amalgams, and they eat a lot of fish. I know that certain fish are supposed to be higher than others. For example, salmon is not supposed to be that high in mercury, but I have patients who do not have mercury amalgams. They only eat salmon. No tuna, no swordfish. Their blood work or their blood mercury levels are very high.

Ann Shippy, MD

I am saying the same thing. I am starting to think that. Pregnant women should never eat fish. Then the rest of us need to consider whether to eat it or how often to eat it.

Nafysa Parpia, ND

I tell my patients to eat birthday cake, like once a year. Know that at a birthday party, you want to indulge in that cake. and so then I have my patients have a fish fast for a month, and then the mercury levels come down. But speaking of amalgams, they must those removed by a biological dentist who is following the Huggins protocol, where they are making sure that the mercury does not vaporize because the mercury can vaporize up and can vaporize down when it is being pulled out. They need a dentist to go.

Ann Shippy, MD

Otherwise, people do not do that, and they remove those noggins. It can tip them over much more drastically than they were before. Even have them, get them a little stabilized, and then take them out. How about you?

Nafysa Parpia, ND

Yes. Sometimes they are just not ready to light up. Later on, we will talk more about methodology, but it is very often something our patients are ready for. I think you are thinking the same thing. They are not ready for detox because detox causes inflammation. They are not ready to kill bugs because treating infections also causes inflammation, and our patients are already highly inflamed. We want to bring the inflammation under some level of control before we start to do those things that we want to do but will cause more inflammation.

Ann Shippy, MD

That may be a great segue unless there is anything else on testing that you want to talk about.

Nafysa Parpia, ND

One more test I want to talk about: I love IntellxxDNA.

Ann Shippy, MD

I do not know where this interview is going to end up in the order, but I just interviewed Sharon Houseman Cohen yesterday. We are on the same page about that too. Tell me more about what you love about Intellxx.

Nafysa Parpia, ND

I love that test because it looks at how different genes from different systems interact with each other. What different genes do patients have in the different systems of their bodies? Then they called the research about which genes can interact with one another back in 2014; remember, MTHFR were the sexy genes? It was the one that everybody was talking about in functional medicine. Now we know it is not just that one gene, but this interplay, the orchestra of genes acting together. It is different in different people’s bodies. Then they have culled the literature to look at what different genes acting together can contribute to specific disease processes. It is giving us a lot of insight into why our patients are behaving symptomatically the way they are.

Ann Shippy, MD

I usually order tests on myself just to see if this is going to work for my patients. When I did the Intelexx test, I felt I was getting a whole encyclopedia into understanding why I have had the issues that I have had with autoimmunity and getting stuff and neurological things for mold and saying, Okay, this makes exact sense. Now that I have those details about what some of those exact mechanisms are, I know more precisely what I can do to be preventive. I do not have these very tenuous run-ins.

Nafysa Parpia, ND

Right.

Ann Shippy, MD

I have new things I need to learn.

Nafysa Parpia, ND

Sometimes patients freak out when they see that test because they think, I have this ahead of me, and I tell them, Let us be happy that we are looking at this right now because we are about to prevent this. Your genes do not need to be expressed. Everything you are doing right now is preventing those genes from being expressed. The reason we are looking at this right now is that it gives some insight as to why your particular symptomatology is happening right now. Then they feel this sense of relief. They’re, oh, this makes sense. This is why I cannot get rid of my metal. I am seeing patients who have chronic Lyme disease, chronic mold, and all these other co-infections and concurrent infections, along with their high environmental toxin load. I am sure you are seeing it too. They have many snippets in their genes for detoxification or in their inflammatory pathways.

Ann Shippy, MD

Exactly. There’s always some in both. Then, often, the histamine pathways, Yes. All of it.

Nafysa Parpia, ND

Yes.

Ann Shippy, MD

Okay. Then the testing that we have talked about is what you should do to test for mold.

Nafysa Parpia, ND

Okay. When I am thinking about molds, rather than just how they can affect my patients in various ways, I am also thinking about whether they are allergic to the mold spores themselves. For that, I am looking at mold IgG allergens, not IgE. We can look at IgE too, but usually, they come out zero, and in looking at the IgG, that is where we see the possibility of sensitivity. We learned this from the old EMT doctors who taught us that, as doctors at Gordon Medical back in the day, they taught us that the IgGs are the proteins that we make in response to seeing molds and that we may have a sensitivity to them. I am looking at that.

Ann Shippy, MD

Due to that, through LabCorp or one of the specialty labs?

Nafysa Parpia, ND

Just Labcorp. I do not have the specialty lab that does it, but it is good that most people’s insurance covers that.

Ann Shippy, MD

I know this. Yes.

Nafysa Parpia, ND

Which is great. I am wondering if they have an allergic response to the mold itself. Then I am wondering: do they have a high load of mycotoxins? Then I am wondering, do they have an allergic response to mycotoxins? I am wondering where the mold is. I am wondering if they have an exposure or a current exposure. Where is that exposure? There are so many things I am thinking of and considering when I am diagnosing my patients with mold or mycotoxins. There are many tests for all of these various possibilities. Mold and IgG allergens, as I said, to understand if they are having an allergic response to the bug itself or if they have a high mycotoxins load, I was using Mosaic and Great Plains. We can look at IGL now to understand the location of where that mold is. I am thinking about the gut. I am thinking about the sinuses or the skin. So in testing the gut, there is so much testing to do, but in testing the system,

Ann Shippy, MD

You are the first person with whom I have gone into such depth on this approach.  I think it is really important for people to know that it is complex, and we have done our homework to figure out the best ways to get enough of the puzzle pieces together to understand the person.

Nafysa Parpia, ND

I love that you went through puzzle pieces because each person is unique. I am running the same tests on people with similar symptoms. But really, how’s the person going to respond? The treatment is different. Their genes already have

Ann Shippy, MD

Have a lot of things to address.

Nafysa Parpia, ND

Yes. I am looking to see if there is a fungus in the gut. I am looking for them in the sinuses. In microbiology, the X-test is for the sinuses, where we can look for bacteria, fungi, mold, biofilm, and the gut. I like the Parasitology Center test for two reasons. They are more sensitive to Candida in the gut, but they will find the nematodes of parasites. Earlier on, they talked about how parasites are common in this patient population. They sure are. Most PCR tests that are great can pick up on parasites because, within 2 hours of somebody whooping a parasite, an enzyme that makes them disintegrate makes them impossible to find on the PCR test. We cannot get that stool sample to the lab within 2 hours. The Parasitology Center Test in Mexico, I do not envy the person’s job, but their equipment to manually look through the stool to look for eggs. It is very often the eggs of the nematodes. When I am finding the eggs, inevitably I am finding the candida because, remember, parasites sequester.

Ann Shippy, MD

Yes, this is great. This is a great tip because I have not found any U.S. companies that do a great job. and I have not tried this parasitology center. I am going to definitely get their information from you and send stool samples and sometimes blood because sometimes they will pick up the ticks in the blood. After all, they are looking at high-powered microscopy and special stains. I sent it to Nigeria.

Nafysa Parpia, ND

I have not used that lab.

Ann Shippy, MD

Yes, it has been great. Yes, it is a little pricey. The samples have to be sent on Wednesdays, and it is a little bit for patients to orchestrate it all. I will get this information from you afterward. Thanks for that tip.

Nafysa Parpia, ND

Yes. Absolutely.

Ann Shippy, MD

Because I am seeing it too. If you still have that push of information about the colonization or infections of the fungal families or the parasites, it is much more difficult to get things to start to come into balance.

Nafysa Parpia, ND

Yes, so it is a puzzle piece.

Ann Shippy, MD

Truly beautiful. I love your approach. This is a very comprehensive methodology. I think by doing this comprehensive look and thoughtfulness that you are doing, the way that you are thinking so deeply about each person helps to expedite their healing process, it does.

Nafysa Parpia, ND

Doing all this testing can be very expensive, but we tell them this upfront when they call the front desk for an appointment right away. We tell people you might spend a lot of money on labs, but this is because these patients have been to a minimum of five doctors, usually ten at least. They have been to so many other places that they have not had any diagnostics.

Ann Shippy, MD

Diagnostics, yes.

Nafysa Parpia, ND

Just the basics tell us they are not dying. But thank God, we know that. But actually, these patients have been shamed. They have been told they are not sick; they have been told they are lying and told they are making up; or they have been told that they are lazy so much that there is just so much trauma. This is a whole other topic in your area.

Ann Shippy, MD

It is. But a lot of times, people do not look sick. They look beautiful. It looks so beautiful. It is hard for people to believe them and then wait until they have done just the basic labs—flying over in an airplane and figuring out what is going on in a leaf on the tree.

Nafysa Parpia, ND

Yes. I cannot find that. We are casting a wide net too. To understand what is going on in medical school, we were told not to cast a wide net. Just look for the thing you think is right, but in complex chronic illnesses, I think it is important to cast a wide net. We do not need to do that in the acute model of care. There is no model of care for chronic illness. That is what we are creating for ourselves through our experience. Because it is a complex illness, it is all about inflammation. It is usually about several toxins, several infections, the structure, and integrity, just going back to the beginning. That is what we were talking about. We have to understand what it is in each patient that is driving that inflammatory process.

Ann Shippy, MD

I am with you on really individualizing the treatment for each patient. What I would make sure we keep some time for, though, is when you find somebody who does test positive for Lyme and has mold exposure. How do you start a very complicated cause?

Nafysa Parpia, ND

It is very complicated. It is very common. I am sure you are, too. I am going to say that in the majority of my patients who have Lyme disease, there are also active mold issues, or the majority of my patients who come. They say I have mycotoxins; I have a mold issue. They run down their symptoms, and I think you are sounding like you might have the tick-borne disease as well as these other infections. Let us test them. Eventually, most of the time, it is 80% of the time that both are there in my patients and so I want to modulate the immune system first because I know that once they start to treat the infections and once I start to detox the patient, more inflammation is going to be created. At least some patients have mast cell activation syndrome. Do you have someone talking about mast cells in the summit?

Ann Shippy, MD

I do, and it comes up in every talk.

Nafysa Parpia, ND

Good. Okay, so I do not think.

Ann Shippy, MD

Where we are going to go, yes.

Nafysa Parpia, ND

Perfect. Good.

Ann Shippy, MD

Good. Yes. But I would love for you to still include the basis of how you think about it and where you include it in your process.

Nafysa Parpia, ND

Sounds good. I am starting on it very early because most of my patients do have mast cell activation syndrome, and I tell them mast cells are located in various parts of the body. They are in the bones, they are in the muscles, and they line the nerves in the genital urinary tract. People have symptoms in all of these areas. Mast activation syndrome is a secondary illness. There is one thing I want to talk about, which is that when we have Lyme disease, mold, and all these other illnesses, these are the primary triggers. What happens is that those primary triggers cause inflammation. That inflammation causes immune dysregulation. The inflammation and immune dysregulation cause secondary illnesses. The secondary illnesses are those of the hyperactive immune system. Typically, autoimmune conditions, such as mast cell activation syndrome, have a hyperactive response to viruses and other bugs, so they have this hyperactivity in the music. I want to come there first. I want to start putting some water on those secondary illnesses that have been caused by the primary ones, like Lyme or mold. I often use their basic magic to become absolute magic in my practice to start modulating the immune system.

I might use things like KPV, which is a mast cell stabilizer, and BPC-57, which brings inflammation down in the gut and also in the rest of the tissues. TB4-FRAG, to modulate that hyperactive immune response, and possibly Xanax. I am using those peptides to modulate the immune response first. I am also treating mast cell activation syndrome, some of it with those peptides, and sometimes, very often, I am using Ketotifen, often because it is a mast cell stabilizer. People need to take it a few times a day and a higher dosage at night, or Chromolyn, to calm the mast cells in the gut. Also in the genitourinary tract, I found that when patients have symptoms of a UTI, they think they have UTIs but do not. If you give them Chromolyn, it calms down the genitourinary tract. They stopped having those symptoms of interstitial cystitis. I am modeling the immune response first; I am treating mast cells, and once that is more under control, the patient will tell me, Wow, my psoriasis is gone, or my interstitial cystitis is gone, or I am feeling less pain, or I am feeling less brain fog. The symptoms are still there, but they are starting to dampen, with some starting to modulate the immune system first. Then I want to start to remove the triggers.

Now, typically, before I treat infections like Lyme and mold, I am working on removing toxins from the patient. But of course, we want to make sure that the patient is ready to remove those toxins. We talked about that earlier. I want to make sure they are not constipated or do not have recurrent UTIs. I want to fix their hormones first before I even begin to detox them. Set them up for detox. Then I started to bring their mycotoxin load down. If mycotoxin loads are high or if Mercury’s high, I will bring that down. It is usually not just one toxin; I found that. I am doing multiple detox therapies at the same time. Why am I doing that before I kill bugs? Because when we kill infections, they release toxins, they release biotoxins, and there are more byproducts from dying cells and dying bugs. That is going to create more inflammation in space. Patients are already highly inflamed by environmental toxins, mycotoxins, and the bugs themselves. I modulate the immune system and bring detox down. Then I start.

Ann Shippy, MD

To talk about what you do for detox, what kinds of things do you do?

Nafysa Parpia, ND

Sure. Sometimes people do not have the cofactors available for detoxification. I want to look at their mineral status, amino acid status, and B-vitamin status because those are the cofactors for our detoxification pathway. I can start to try to directly pull toxins out of someone’s cells. But if the person does not have those cofactors available, then toxins are just so common.

Ann Shippy, MD

Almost everyone needs them.

Nafysa Parpia, ND

That is my first step. Just making sure that they have the appropriate minerals and amino acids tested for them, treating that, and even giving somebody minerals and amino acids begins the detox process because I tell patients it is your detox process. Imagine it is a wheel, and I need to press certain buttons to make it turn. Well, the minerals and amino acids are addressing that, and I do not want to put the pedal to the metal on that wheel by pulling toxins off and telling the body, Okay, it is time to begin to detox slowly. Here is what you need to make that happen: the minerals and amino acids, and then I am looking at their genes and thinking about their glutathione. A lot of people have SNPS, and they are good at their pathways. Those people are not ready for glutathione, and yet they need more cofactors. I am looking, speaking of labs, at the Health Diagnostics Methylation Pathway Lab to understand,

Ann Shippy, MD

That, yes.

Nafysa Parpia, ND

Are they under oxidative stress right now? How do we need to support their methylation so that we are supporting their detox system in general? By doing that now, when the patient is ready to have toxins pulled out, we have found the source of the metals and stopped the source. If that is the case or they have a high load of toxins accumulated in their cells and I need to use phosphatidylcholine, we are often using little choline IVs, or we need to assess if a patient is ready for chelation therapy; if that is appropriate, that will happen. But that is a whole other conversation.

Ann Shippy, MD

Which is a whole other lecture.

Nafysa Parpia, ND

Another day.

Ann Shippy, MD

It sounds like we try to do things without that, just getting the body and its detox pathway working better.

Nafysa Parpia, ND

There’s something really important I want to bring up, which is the feeling of safety. I think we are almost out of time. But I just want to bring this up. It is the emotional and spiritual part of healing because our patients feel unsafe. They feel unsafe in their bodies. I can understand why they have symptoms everywhere all the time. How can they possibly feel safe in their bodies? I think that this needs to be addressed. So we are working on that piece with healing. I do a lot of healing myself. We also have other healers with whom we work with energy work, bodywork, meditation, and accessing whatever is sacred to that person. It could be.

Ann Shippy, MD

I said that because accessing the sacred is part of feeling safe in your being. That is beautiful.

Nafysa Parpia, ND

It is different for each person. For some people, it could be indigenous healing practices. It is some people; it is prayer; it is art; and some people are connecting with nature. These are the foundational aspects of our well-being. It is coming home to ourselves, and what is sacred to ourselves is merging with that. I think that is the glue for everything else we can do. We can do all these tests, understand the biochemistry and the genes, get to the nitty-gritty, and have our plans for the patient. But the patient needs to feel loved. They need to feel safe. Once we can bring about that feeling of safety in the psycho-emotional space, it ripples out into the cells, and the immune system feels that the patient knows they can put their defenses down. The immune system will feel that. I think this is a very important part of healing.

Ann Shippy, MD

Yes, I love the way you said that which ultimately really helps. You are helping your patients tap into their bodies and their wisdom and ability to heal by getting them away from the burning of the tiger. They are correct in that their bodies are deteriorating.

Nafysa Parpia, ND

I want people to know there is hope because, well, there is. We see our patients get better every day. The other thing is, as I tell my patients, there is a silver lining to this. You might not know what it is yet, but almost every single patient says, After they are healed, I am happy this happened because I have learned something, I have grown, I have evolved, and I have come more into my internal power. It is a beautiful thing when someone is healed and they say that they found what is sacred within themselves or what the sacred connection is for them in this life journey.

Ann Shippy, MD

I too feel that in my own body, the things that were the hardest and scariest have helped to propel my health so that it is okay. I feel better than I do and leads now to almost 30 and a true healing.

Nafysa Parpia, ND

Right.

Ann Shippy, MD

Beautiful. Well, you are such a gift. I love how you bring this all together with your very analytical mind.

Nafysa Parpia, ND

Thank you.

Ann Shippy, MD

Good puzzle, what a puzzle extraordinaire, and then they bring such a beautiful healing presence and the willingness to think outside the box and learn something new from each patient, and that willingness to help people being in that gap of that uncertainty of how things are going to go and where things are going to go. You just have a beautiful way about here that, I think, makes people feel they are not alone in the journey.

Nafysa Parpia, ND

I appreciate you saying that. Thank you.  I am a reflection of you because you are seeing that because it is you as well.

Ann Shippy, MD

I see that in you, appreciate it very much, and thank you. I am so grateful that you have shared so much of your wisdom. I would like to make sure that we let our listeners know where to find you. I know you are putting out good information all the time and have lots to share.

Nafysa Parpia, ND

Thank you. They can find it at Gordon Medical, and it is GordonMedical.com. We are in the San Francisco Bay Area, and people come from all over the country. Other parts of the world come, and they get treatment, and they get better. 

Ann Shippy, MD

That is great. Well, thank you so much for all of your beautiful wisdom and heart, and I look forward to more conversations. I thought about the ten more I would have with you.

Nafysa Parpia, ND

We work hard and are doing this summit. I am so excited for you. It is going to be beautiful. Thank you.

Ann Shippy, MD

Thank you. I hope it gives hope to a lot of people. Thank you for helping me with your effort.

Nafysa Parpia, ND

Thank you for having me.