Recovery Steps For The Highly Sensitive Individual

Neil Nathan, MD

Thanks for having me on.

Ann Shippy, MD

You have been a pioneer in this field, getting such important information out. I am excited to hear what is coming up. But it got you interested in writing this book.

Neil Nathan, MD

Well, my new book, which I am very excited about, should be coming out soon. As you said, it is called The Sensitive Patients Healing Guide. What got me interested in it was the fact that all of my colleagues kept referring to me as one of their most sensitive patients, saying that they were having difficulty getting well. It forced me.

Ann Shippy, MD

You a lot.

Neil Nathan, MD

But it forced me to learn more and more about that process. When I first started practice, and I have been in practice for over 50 years, I did not know that I saw very many sensitive patients, nor did I think I knew how to deal with it at all. I just knew I did not understand it. Then it grew that as I began to work with chronic fatigue and fibromyalgia, I began to see more and more sensitive patients. That eventually led me to understand that Lyme disease and co-infections were major players in that process, and eventually led me to understand that mold toxicity was perhaps an even bigger player in that process. It was a growing body of knowledge of how to help some of our sickest patients, where they would be seeing other physicians, even going to university centers, and just being told it is in their head or we have no idea what to do with you and realizing that we actually do know a lot and we actually can help a lot of you if you know what we know. In that setting, I began to realize that mold toxicity and Lyme particularly triggered sensitivity in the vast majority of the people that I was seeing who had gotten so sensitive. That was the start of it. Then I became.

Ann Shippy, MD

The curiosity of how to help these patients who were not getting answers anywhere else

Neil Nathan, MD

There is a sickness that I hate, which is that I do not know how to help you go away.

Ann Shippy, MD

I know that should never be said.

Neil Nathan, MD

I do not know how to say that. All I know is that I can see your suffering. If you do not give up on me, I will move heaven and earth to figure it out and come to some understanding about what is going on here. My patients taught me almost everything. Over time and working with sensitive patients, my first few tools were LDA, a low-dose antigen therapy that worked slowly. For people with chemical sensitivity, maybe 50% would get better within three years of giving them this treatment, and EDTA helped some of those patients. I knew I needed more tools. Until I stumbled across Annie Harper’s dynamic neural retraining program. That was, wow, okay, now I am beginning to get it. This is a limbic system issue. With that tool, I was able to help a lot more people.

Ann Shippy, MD

I am just a veteran. I cannot explain why that is a little bit more because we have not been there. I think it is an important thing, an important tool for people to understand.

Neil Nathan, MD

Yes. But then I realized there were more pieces to this puzzle. The more you learn, the more you learn. Of course, that is how it works in this world. then I came across Stephen Porges’s work on the vagal nerve importance, and then by combining Steven’s work and rebooting the Vega system, Annie’s work, and then later Ashok Gupta’s work and rebooting the limbic system, I helped more people. Now we are talking about 2016. I came across Larry Ephron’s book, Never Bet Against his book on message activation, which just absolutely opened my eyes to, my goodness, there is another big player, if you will, another elephant in the room. As my learning increased exponentially, we began to have more and more tools to understand what made our patients sensitive and how to treat it. Now we understand some of the physiology behind it, and we have tools for working on that. We also understood the triggers. 

The biggest one in my experience is mold toxicity, followed closely by Lyme and Bartonella, and not far behind that increase is EMF sensitivity. Those are the biggies, and there are others. This is a long-winded way of describing a little bit of how I got to be where I am, and I just felt that there were so many patients out there who are sensitive. It is estimated that there might be as many as 35 million Americans who have some degree of chemical sensitivity—sensitivity to light, sound, touch, food, and EMF—to varying degrees. Many of them have no idea that there is help. That is why I wrote the book. Many of them are being told, You are just too sensitive, or they will smell mold. What other people do not? That is very real. I have known that for a long time, but they are being told—no, you are imagining it. This is in your head. My concern has been for those patients who have been marginalized, criticized, and not believed that, okay, what you have is real. We know what causes it, and we know how to treat it. That is my excitement about what we put together here.

Ann Shippy, MD

It is exciting. I do not think there is anything out there. We have not touched much on the EMF aspect and how that fits together with mold. Would you like to spend a few minutes on that?

Neil Nathan, MD

Yes, sure.  Again, EMF sensitivity started with a few cases, and now there are millions. It has gotten worse and worse as the EMF pollution in our world has increased. The shift from 4G to 5G is not just number one. It is an exponential increase in the amount of electromagnetic exposure that our patients have. Again, people go. I am in the same room as you, and I have the same exposure, but I am not experiencing that. It is not appreciated that we are all biochemically and genetically unique and that for some people, a little bit of exposure will throw them under the bus, and other people can handle that. But it does not mean that those people who are experiencing it are psychogenic. This is real sensitivity. The EMF issue is a huge, increasing one. I first started to see it in the mid-nineties. I was working at that time with Dr. Norman Shealy in his clinic in Missouri, which was a pain clinic, and Norm had come across people who were just beginning to see and describe this EMF sensitivity. When they were around EMF, their brain shut off, they could not think, they became fatigued, and they sometimes had some odd neurological symptoms—pseudo seizures, dyskinesias—just things that were not seen before. Norman wrote a paper back then called Electromagnetic Dysthymia. what he would do in our clinic, and he would document it.

He was doing brain mapping, which is a method in which we take a little band around the head or some clips on the ears, and we can measure the brainwaves in 21 different areas of the brain. We have, for example, beta waves, which are the waves in which we think clearly and can function and get through the world. We have alpha waves, which are waves of relaxation. We have theta waves, which are the waves of creativity. Then we have delta waves, which means the lights are on but nobody’s home. What Norman would share with these sensitive patients was very real. He would have them getting ongoing brain waves, mapping, and then slowly bringing an electrical clock down toward their head before it even got to their head. EMF, produced by an electrical clock, would shift that patient’s brainwaves from beta or alpha into delta, and they would just literally shut down. This was the beginning of proving the reality of this particular event.

Ann Shippy, MD

Wow. Well, so the main thing is that when you start to think about EMF, a lot of times the patient already realizes that they are sensitive because they feel a difference in how their brain is working.

Neil Nathan, MD

It is way more common than people realize. When someone says to me, If I sit in front of a computer for more than 2 hours, my brain gets foggy, I cannot think I have become unusually fatigued. That is the EMF sensitivity. There was a huge increase in EMF sensitivity when smart meters came into effect. At the time, I was practicing in California, and the local power companies were insisting that unless you chose to opt-out, they were going to install these smart meters, which is a way that they did not have to bring meter readers out to each home so that they could get a reading from a central location. That is great. But the way they worked was that every 10 seconds, these meters put out a pulse of electricity, which is quite powerful. Within a couple of weeks of installing smart meters, I had a bunch of patients come into the clinic who had been professional and talented, bright people who could now not think their way out of a paper bag. They completely shut down. They were baffled by it and did not understand it at all until we traced it back to the smart meters. Some of those people had to move to rural environments and live in the woods. If they were within half a mile of another person in the woods who had Bluetooth or some type of wireless going on, it would shut them down. This is very real.

Ann Shippy, MD

What do you think predisposes these patients to be so affected by this?

Neil Nathan, MD

Could you speak up?

Ann Shippy, MD

What are you?

Neil Nathan, MD

Think? That’s better.

Ann Shippy, MD

Where do you find the predisposing factors? Why are some patients so much more susceptible to EMFs?

Neil Nathan, MD

Well, the big surprise is mold. The vast majority of my patients developed EMF sensitivity. When you test their urine, they have no toxicity. But I have seen it from Bartonella. I have seen it in some other issues, and for some people, it just gets triggered in them. Marty Paul, who wrote a chapter in my book, has researched the biochemistry of EMFs, and it turns out that it is related to calcium-related voltage gates and that it is an actual physiological process in which those become sensitized. I would use the word inflammation of some kind so that anything can trigger it. COVID, for example, created a huge sea of inflammation. For our patients, it is a big trigger for all of these various things.

Ann Shippy, MD

I am seeing the same thing: yes, COVID is definitely for people, and the vaccine is for people that are in toxic mold, that the effects of COVID, the lasting effects of COVID are so much more profound, or that the side effects from the vaccine are so much stronger.

Neil Nathan, MD

Yes, the way I explain it is that it adds another layer of inflammation to an already inflamed system, which for some people is additive. But for some people, it is exponential.

Ann Shippy, MD

Let us talk about more of the predisposing factors. What are the things that you think are part of the reason why one person might be fine, one spouse might be totally fine or not noticing anything significant, and the other spouse is barely hanging on?

Neil Nathan, MD

Well, some of it is genetic, and some of it is the whole life experience that someone has up to this moment in time. For example, we talked about the trifecta, or limbic, vagal, and mast cells, which are the things that are creating this sensitization process in the limbic and vagal areas. That is neurological, not psychological, and in the mast cell, it is an immune cellular process. Several different processes create sensitivity in the first place. Anything that affects the limbic and vehicle systems makes them more vulnerable or prone to this happening. As an example, none of us have had perfect lives.

Ann Shippy, MD

I do not know anyone.

Neil Nathan, MD

Yes, maybe. Maybe there are some I do not know. But they do not need medical care, so they do not come into my office. Depending on how your life starts, maybe you were even a baby born in a difficult childbirth that might have started in childbirth or might have even started in utero. But then if you had recurrent ear infections or throat infections and you needed to go on antibiotics or you needed several surgeries for any number of conditions, or if you grew up in a household in which you did not get your needs met perfectly and, in the worst cases, abuse of sometimes physical, sexual, or emotional abuse, or it could be from no attention at all from parents who worked two jobs and were busy and you just did not get any attention. But that sets the thermostat of the limbic system for not feeling safe—both the vehicle and the limbic systems. The key element here is safety. Their job neurologically is to protect you by monitoring the stimuli in your environment, both internal and external, for safety. If they do not think you are safe, they will get your attention by giving you symptoms. Now, those symptoms may be unpleasant, and you might get mad at your limbic system for why you are shutting me down this way. It is not trying to hurt you. It is trying to warn you. I do not think you are in a safe place. Please get out of here. What you are getting is a chemical, a food, or something you are getting exposed to. Neurologically, you are not safe. Please do something about it. That’s a job.

But what happens is that, through whatever number of repeated traumas or stressors you have been through throughout your entire life, the limbic system becomes increasingly hypervigilant. We have a tag team with the vagal system, which does the same thing. Both of those neurological symptoms are out there, scrutinizing stimuli for safety, but I do not think you are safe, so I need to shut you down or teach you what the problem is. In that milieu, with that background, and we all have different components that we have all dealt with differently, some people compartmentalize that, put it in a box that it would go away, and it almost always will come back and bite you back if you do it that way. For other people who may have dealt with it, maybe they learned relaxation skills or meditation or something and chipped away at it. They quieted that system, so they were less vulnerable.

But regardless of how it went, depending on the extent of those stimuli, the limbic and vagal systems were predisposed so that if you had a trigger, exposure to mold, or infection with any number of things could be a virus; it could be Lyme or Bartonella, chlamydia, pneumonia, or mycoplasma infections. It is a variety of infectious and toxic agents, and when we talk about mold, it is perhaps the most obvious and easy to measure of the environmental toxins because hundreds of thousands of chemicals in the environment did not exist 50 years ago, and I know it is shocking for the public to hear this, but 500 of them have been tested for their safety in human beings. We have a boatload of toxins in our environment, which is the straw that breaks the camel’s back. then we are going to spiral into increasing sensitization of our neurological symptoms. There is a neurological term for what we call kindling, in which once you start to get sensitive to something light, sound, or chemical, it gets worse if you do not treat what is causing it. That is the vicious spiral we are dealing with here.

Ann Shippy, MD

This is great. You are finding that you have got to do the testing to get to the root cause, to find out what is stimulating the overload, and then also address the limbic and the polyvagal. What do you find the most effective ways to address the limbic you can differentiate the polyvagal, and then we can do some of the others, which cause effects on mold.

Neil Nathan, MD

If I am putting this together in a vaguely logical way, the first thing is that we have to quiet those systems that are dysfunctional. Again, I call them the trifecta, limbic, and vagal. We need to treat all three systems, and the good news is that we can. We have several good methods that we can use to quiet the limbic system. The ones I have used the most are the Annie Hopper DNRS program and the Ashok Gupta Amygdala Retraining program. But there are some newer ones that I also like a lot. Cathleen King has Primal Trust, and David Hanscom is a pain specialist who worked on the limbic and vagal systems. More from the pain perspective. He has a program called D.O.C. (Direct Your Own Care), and I have sensitive patients who are limited by excruciating pain; they can barely get through their day. That might be one I lean towards in patients where the pain is not the primary concern, like Annie Hopper and Ashok, who are my go-to’s for treating it. But so that is.

Ann Shippy, MD

Great. I did not know about him. That is good to know.

Neil Nathan, MD

There are some more coming out as well. Annie and Ashok pioneered it, but as with all pioneers, people started to tweak it or have their little way of doing it a little bit differently, and everyone’s got their preferences.

Ann Shippy, MD

I think different things resonate with different people. I think for our listeners, maybe going in and looking at the different programs and seeing which one resonates with them the most,

Neil Nathan, MD

That is what I ask people to do. I tell them to look at Annie and our short videos. They have some free videos that talk about their program to get a feel for the sound of their voice and their energies. Which of them do you resonate with better? They are both excellent programs. The key is there, and I have to do it.

Ann Shippy, MD

You have to do it.

Neil Nathan, MD

You have to keep doing it until the mold is gone because the mold or an infectious component will keep inflaming those brain areas until it is out of the system. Now, once those things are gone, those treatments are unnecessary. They go away.

Ann Shippy, MD

It is great.

Neil Nathan, MD

Yes, to expand on that, that is the vagus piece. For the vagal piece, I will give a smorgasbord of things that I particularly want to treat it with. I will start with some exercises that were developed by a fellow named Stanley Rosenberg and written about in his book, Accessing the Healing Power of the Vagus Nerve. Those exercises, which would take 5 minutes a day, are a good start. The fellow who wrote that book was a Danish cranial psychotherapist, and he intended those exercises to accompany cranial work. I am a huge fan of osteopathic cranial work, so it is very gentle and super helpful. I encourage people to find someone in the area doing that as a part of their treatment.

Ann Shippy, MD

I grew up a huge fan of that too, and I even see the difference for myself when I go out for treatments. I am glad you brought that up. I think it is an important tool.

Neil Nathan, MD

Well, although I am an M.D., like you, I started studying osteopathic cranial work 40 or more years ago. The osteopath took pity on my having so little and took me seriously. It has become a huge tool that I love to use. It is a way of using your hands to communicate, love, and care in a way that words cannot.

Ann Shippy, MD

Write to the nervous system.

Neil Nathan, MD

Many people who come to us have seen many practitioners before they get to us. They do not trust doctors anymore because they have been dismissed, denigrated, and told it is in their heads, and they know that that is not true. So just giving words to patients does not always do it. If I can use my hands to do a treatment, even on a first visit, my hands can communicate something above and beyond what my words can, and even if people are not verbal about it on a deep level, they can feel it. It is one of my favorite things that I have learned to do in my long career.

Ann Shippy, MD

That is wonderful.

Neil Nathan, MD

Other than that, I love frequency-specific microcurrents. It is a terrific device with multiple things it can do for the body and a healing mode. But it has a great program for the vagus nerve, which is called concussion. They have a program for PTSD, which is the underlying problem with the limbic and vagal systems—these series of events that sensitize us to being hypervigilant in our environment. Let me add that since both the vagus and the limbic system are hyper-vigilant, if you only quiet the limbic system and do not work on the vagus, you are going to stay hyper-vigilant, or vice versa. You have to do both bingo and limbic treatments concurrently to quiet the system down. That is just an important concept to have.

Ann Shippy, MD

That is a lot of good tips.

Neil Nathan, MD

Other vagal strategies: The brain taps, and I especially like what we call vagal nerve stimulators. These directly stimulate the vagus nerve. My favorite is a little expensive. It is the Gamma Core, an inexpensive one. It is not quite as powerful as Apollo Neuro. It is a band that you can wear on your wrist. My problem with all of those is that the company will tell you to use it for longer than anybody else should, especially if you are sensitive. For example, Apollo Neuro, the company, will say to wear this for 5 to 8 hours a day. If you are sensitive, please do not do that. I have had one or two patients capable of doing that. I tell my sensitive patients to just wear it for 3 to 5 minutes once a day and slowly work up to 5 to 10 minutes once, maybe twice a day. That’s it. As with everything in the world, if some is good, more is not necessarily better. 

Our patients have to learn that the hard way. But I am going to start with the very gentle use of a vagal stimulator. The gamma core is a device that you rub over the vagus nerve in your neck for 3 to 4 minutes, once or twice a day. That might not sound much. It is a powerful treatment. That is the vagus piece. The third of the trifecta is mast cell activation, which is intimate and highly connected to limbic and vagal. When we are talking about it for discussion purposes, I talk about each one separately, but in reality, in the body, they are interwoven and interconnected. You have to treat the limbic, vagus, and mast cells to quiet somebody down.

Ann Shippy, MD

What do you want to do for mast cells?

Neil Nathan, MD

As much as they will tolerate it? Mast cells are complicated. As mast cells release hundreds of biochemical mediators into the body, many of which are inflammatory, adding an inflammatory piece to an already inflamed system just makes everything worse. To start with an H1 and an H2 receptor blocker. What that means is that histamine is one of the more important materials that mast cells release. H1 and H2 blockers are simply receptors or cells that respond to histamine. If we block it, then we are going to mute the effect of histamine on the body. I am sure the listening audience has tried H1 blockers. They are very common with things like Claritin, Zyrtec, Allegra Cytosol, and the H2 blocker Pepcid. I ask my patients to start with light doses of those, and then if they can work up to taking them twice a day, 

I will add what are called mast cell stabilizers. These are natural things like quercetin or pyrimidine, which is an extract of perilla seed, or they could be medications like cromolyn sodium or ketotifen, often depending on whether a patient prefers natural things or pharmaceuticals. It is not even a preference that, for some patients, they respond better to pharmaceuticals, and sometimes they respond better to natural things. Many of my patients are prone to wanting the natural. That is fine, but if it is not doing what they need, then we need to go to what works better. That is just common sense. 

Then I will use DEO materials. There was an enzyme, diamond oxide, which the body naturally makes to break down excess histamine. I want to add that as well. to use a trip trace inhibitor called All Clear. There is more, but that is my basic starting point, starting with light doses and slowly working up to comfort. If anybody is taking something and it is making them worse, that is too much. They have to be very careful with sensitive patients to start at very low doses and then be into it. As an example of that, quercetin is very important. About 20% of patients cannot take it. You must exercise caution when using it, and those who are genetically predisposed to CMT SNPS are unlikely to benefit from it. 

With the sensitive patients, I might start them on an unusually low dose, which you can find in a product called Neuroprotek LP, which was designed for children, meaning that dosage-wise, Neuroprotek LP has only 40 milligrams of quercetin, whereas most quercetin preparations are 500 milligrams. It starts so much more gently. I had thought about it as getting under the limbic radar. If you come in under the limbic radar, the limbic system goes, yes, that is just a little bit. I can handle that. We are good. We are good. If you can do that, the limbic system is less scrutinizing of that substance as it is not yet up. That is a key way to approach it.

Ann Shippy, MD

That is great. Great information. I did not know about that product. That is easier than emptying capsules or getting powder. That is awesome.

Neil Nathan, MD

Sometimes you have to tamp down capsules. For some people, they are not reacting to the substance but to the filler. With things like H1 and H2 blockers, some patients need to have them made by compounding pharmacies. They are in much purer form. Again, this is a huge subject for a whole article. There were 11 on this alone. There are whole summits on this.

Ann Shippy, MD

Yes.

Neil Nathan, MD

But important. I just want to be sure we are including it in the dialog.

Ann Shippy, MD

It is so important. Yes.  Where do you go next?

Neil Nathan, MD

Well, once we acquire the system, once a patient feels safer, they can take the substances they need to fix the trigger. For most of my patients, mold is a big deal. For some of them, it is Lyme, Bartonella, or EMFs, but I generally experience that within six weeks of doing limbic and vagal retraining. The vast majority of my patients tell me it is so much better. Then, if we add the mast cells within a couple of weeks of that, it will be much better. As they share, oh, I am so much better; I can do things I could not do before. I am not as sensitive as I was. Now they are ready to treat them all. For many of them, they have tried to treat the mold they took. They followed the directions on the bottle, and they took a couple of capsules of charcoal. Horrible. They felt terrible for weeks. They took a couple of capsules of clay and felt terrible—chlorella, all of the above. Maybe they started with cholestyramine, which hit even harder. They already know at this point that they are sensitive. 

If we take a good history, they have already told us I tried then, and boy, I do not want to do that again. That was terrible. Okay, they announced I am sensitive and I have to do this preparatory work first, but they are going to get well. We had to get the mold out or fix the infection. Again, I do not want to overstate it, but mold is the biggest of the issues that I have seen. If we can get the mold out, all of this goes away. The mast cell activation and the vehicle sensitization go away, but you have to get them able to take the blinders first. If they can take the binders, then we get into antifungals, which for many of them become an important part of treatment as well. That is the next step.

Ann Shippy, MD

Yes. This whole practitioner world, those of us treating patients that are being affected by mold, is a controversial topic about how to treat the infection. I would love to spend a few minutes on your thoughts and the infection.

Neil Nathan, MD

It is not controversial in my world.

Ann Shippy, MD

Mine either, but some people may have alternate views.

Neil Nathan, MD

There are people with alternate views who state strongly the way I will state strongly that it is. But I think that, for whatever reason, they have not kept up with the research.

Ann Shippy, MD

I agree.

Neil Nathan, MD

Their position was stated ten or 15 years ago. They held that position, and I know many of those people personally, and they just have not kept up with the research, which means anyone who’s followed what is going on has realized that getting a urine mycotoxins test is essential information not only for diagnosis but for treatment. It gives us a blueprint of what binders I need to get my patient to get these toxins out of their body. Now, for some people, they do not need antifungals. If it is just toxins in their body, they will get well, just with binders. In my world, they are few and far between.

Ann Shippy, MD

Mine too.

Neil Nathan, MD

When I started, I saw a few of them as our colleagues referred their more difficult patients to me. I do not know. I have not seen it in a very long time. Almost all patients have colonized. We have methods of documenting that with an old test. It is not a perfect test, but when patients are not improving with just binders when their urine mycotoxins tests are going up and not coming down, that is pretty clear evidence that they have colonized, usually in the sinus or gut areas or both. For example, we recently had a chance to talk with Donald Dennis, who is a leading EMT surgeon in the country and works with scientists, and he just chuckled. If you tell them that mold does not colonize, they just look at it. I can see it when I do my endoscopy. Every time I look at it, I can see it. It tells me it does not exist. I can culture it. For those people who say that mold does not colonize, I just think they are mistaken and they are missing an important component of treatment.

Ann Shippy, MD

An important part of treatment is hard to get. Well, if you got one, I would call it not just a station infection that is producing mycotoxins in the body, but an external exposure to them. It is challenging to get the body to recover.

Neil Nathan, MD

It even makes sense when Joe Brewer, who did some of the original work on this in 2013 with his first 100 patients, published it in the medical journal. By the way, that was a groundbreaking paper. He took 122 people, one hundred and twelve people with chronic fatigue and fibromyalgia, and he just measured urine mycotoxins; 92% had them in their urine, and the vast majority of them got cured by treating them all. For me, that was a landmark paper trying to convince the world that what we are calling chronic fatigue or fibromyalgia may be something else that has a specific cure. If we look for it in that same paper, Joe and I were friends at the time; we were sharing our experiences and trying to put these protocols together. But he found that if he asked patients, Is there any mold in your current environment? They would say no. Often, they were wrong, by the way, because they did not look hard enough. 

But for many people, it would be no, but I was living in a moldy house three years ago, five years ago, ten years ago, and now 20 years ago. Joe realized that the only explanation for that was that they had colonized in their exposure. It makes sense. It helps people understand why, if they leave a known moldy environment, a few will get better and most will not. It is, well, if this is mold toxicity, I am leaving the environment. Why do you not plan on being better? Because it is in you and it is making the toxins continue, it makes sense. It has a logical or scientific basis. Again, I suspect this is what you wanted me to address. In my world, there is no question about mold colonizers and the importance of treating them as an integral part of the treatment process.

Ann Shippy, MD

What are the most effective ways that you see in treating it?

Neil Nathan, MD

Well, I think of treating mold as three main things. First, be sure that you have evaluated the environment. What all of us agree on is that you cannot get well if you stay in a moldy environment, which is unfortunate because it is a very difficult thing to work around but essential. You can do better to some extent. That does not mean we do not treat you if you are in a moldy environment, but it is super important to urge people to evaluate their environment and either remediate it or move, not just for themselves but for their families. It is just so important. That’s step one. 

Number two: use the binders that work on the toxins we find in the urine test. In my world, urine mycotoxin testing is the most accurate and useful measure. If you want my bias, having worked with all of the different labs that do those measurements, I find RealTime the most consistent and accurate. Other labs do okay. But when I send samples to all of the labs, I get the best information in RealTime. By the way, I have no working relationship with RealTime. I am not on their payroll. I am not anything to them. That is just my opposite clinical experience.

Ann Shippy, MD

That is very helpful. Thank you. 

Neil Nathan, MD

I have a mentorship program for physicians, and we have almost 200 physicians in it, and we share our experiences. These are all people working on the front lines here. What I am saying would be consensus for the group-specific ones and other tests as well. But I think that this would be a consensus statement from the group. Just for physicians out there, if you are interested, I do this mentorship program with Jill Crista, who is a fabulous naturopathic physician, and Jill and I teach both the, I will call it allopathic, although nobody who knows me thinks I am an allopath. The allopathic and naturopathic approaches are not just mold; they are environmental toxins; they are Lyme co-infections. 

We are teaching physicians how to get comfortable working in some of the most complicated areas where we have ongoing mentorship programs and where we, the group, present case studies. Then we have a ListServe where we communicate with each other about questions, etc. If anyone’s interested, I would invite you to join it. If you go to my website, which is simply neilnathanmd.com, there is an invitation there if people want to join it.

Ann Shippy, MD

I did not know you were doing that. That is great because we are not taught that in medical school.

Neil Nathan, MD

No, you were not. It has evolved into a wonderful support group for all of the physicians there. I love the energy of the group. It is so nice that people have colleagues that I am struggling with. Where do I get this substance, or how do you order it? It is just a how-to that makes things more doable for all of us who are trying to be on the front lines and figure all of this out.

Ann Shippy, MD

That is great.  We got them out of the environment. We found the binders.

Neil Nathan, MD

Okay, now that I have antifungals, I usually start treating the area of the body that is most symptomatic. If someone has particularly symptomatic sinuses, I start there. If their symptoms are more GI-related (gas, bloating, distention, diarrhea, constipation, or heartburn), then I start on the gut. I would like to add for those of you out there that in functional medicine we always teach, to start with the gut. Get it working before you do anything else. In this particular case, it does not apply. You have to get the mold and candida out first for the patient to be able to respond to all your other wonderful treatments for GI issues. It is just what I want. I cannot count on that. I have seen endless patients who have spent three years working on their gut not getting anywhere because they never were. They were not addressing mold or Candida. I just want both patients and physicians out there to share my experience with that. 

But having said that, if I were going to treat the sinuses, I would typically use a colloidal silver preparation. I like Argentyn23, and then I will use an antifungal-based nasal spray based on the patient’s sensitivity. If they have a strong constitution, I will use an amphotericin B nasal spray; if they have a medium constitution, I will use 1% itraconazole or 2% ketoconazole. If they are really sensitive, I will use a statins-based nasal spray by humidification process with an inhaler. But it depends on my perception of the patient’s compliance, which is that I squeeze nasal sprays for people who are going to bulk at doing something more than that. For people who will do anything I ask, I go to more elaborate ways of administering it. It just depends on the patient. then I will add.

Ann Shippy, MD

Are you speaking about the nasal rinses or the nebulizer?

Neil Nathan, MD

Nebulizer.

Ann Shippy, MD

Okay.

Neil Nathan, MD

A nebulizer or atomizer is another. I said it was a name that wasn’t coming to the tip of my tongue. I will add to that a biofilm-dissolving agent. I particularly like B-spray. But there are others. The B is for bacitracin. The pharmacist will call it in your name, and the E is EDTA, which is the biofilm-dissolving agent. A lot of people were using B.G. spray. I took the G out many years ago. It is gentamicin because I was having too many side effects from it, and I thought it was creating antibiotic resistance to the extent that I did not want to see. That is the comment. That is for the sinuses.

For the gut. I will typically start if they have Candida, and most of my patients will. I will typically start with my statins and maybe add some different biofilm dissolving agents, either Interfase Plus, BBalance, or M.S. BioFilm One—those are my two favorites. then for now, an antifungal either Spore or Knox, which is Itraconazole or Amphotericin B. It scares some people to death if they do not understand that Amphotericin B taken orally has no side effects because it is not absorbed. You cannot get a die-off from that if you use it in too strong a dose; that is it. If you get the package insert for Amphotericin B and you read it, please do not do that, patients; it’ll be scarier.

Ann Shippy, MD

Yes.

Neil Nathan, MD

Irresponsibly because those are the side effects of intravenous amphotericin B, not oral. It is safer. But I also do spore knox, especially if I think there is any involvement in the lung or any other issues. If I want a systemic effect, then spore-docs will be my go-to. That is pretty much how I approach it.

Ann Shippy, MD

Very comprehensively. I know this is great. I love the way you laid all this out, and it is so logical with the order that you are adding in. It makes me say yes. say yes. how long.

Neil Nathan, MD

I think I am methodical and logical, but I know I have been accused of other things throughout my career.

Ann Shippy, MD

How long do you find that people need to be treated with the antifungals?

Neil Nathan, MD

Usually a year or more, and that shocks a lot of people. They go, my goodness; that is what it takes. When I say a year or more to have patients in my office, I will then say, You did not hear the or more. Please do not come to me in a year and say, You promised I would get your well in a year because I am not promising that it can take longer. I have had people take two, three, four, or even five years to get well, depending on the load that they were exposed to. Usually, when it takes longer, it is because there is some exposure going on that they are not aware of. but that is a reality. When I tell patients it is going to be a year or more, I say, Hang in there, stay disciplined. You will get better slowly and surely, even though I know you are on the right path. This will not be as fast as you want it to be. Well, this is what it takes. Hang in there.

Ann Shippy, MD

This is great. I so appreciate you spending time with us. I am also so interested in the fact that the hard-core science side of you is now reading the literature; you are putting these together, you are putting sentences together, you are plowing new ground with helping these patients get well, and you are such a collaborator. I love how you have collaborated with people to understand these puzzle pieces, but then you have a little bit of a woo side to you, and I test it. I just love it. If you take a few minutes and talk about one of your other books, the Energy Diagnosis book.

Neil Nathan, MD

I would not call it a woo side.

Ann Shippy, MD

Me either, but I

Neil Nathan, MD

I would call it a recognition that intuition is a super important component of what we do in medicine. You have been doing this for over 50 years, not just in myself, but I have taught countless medical students and residents over the years, and when I watched them operate, when I watched their actual process, you could see that they were taking in information and then coming up with a solution not completely based on the information they had taken in, which is what intuition is about. It is about sharing your life experiences with people, listening carefully in detail to their stories, and getting a feel for what it is they have. This may sound odd, but having treated three or 4000 people with mold and three or 4000 people with Lyme, there is a feeling you have when someone sits in front of you in your office and they are describing their symptoms. I know what that is. I have heard that before. This is a mold story. This is a Lyme story. This is a Bartonella story or this, or conversely, you could call it those things, but this does not sound like Mold, Lyme, or Bartonella. Something else is going on here. Is this not fitting with what I have felt over the years?

My book, Energetic Diagnosis, was about intuition, how to tune into it, how to use it, but mostly how to honor it. Because I often find that not just physicians but patients have a strong sense of what is for them, but they get talked out of it. Invariably, in my experience, that sense is correct. Again, on my part, I have learned to trust my patients’ intuition that if they have a strong sense that this is something they want to look into, we are going to look into that and take the other stance, which I know better than you because I am a physician and I have studied this, so I know you do not know these things. I am going to do what I want to do. I found that that strategy does not work very well; I am just meeting my patient for the first time. Why would my intuition be better than theirs? They have lived with their bodies their whole lives. That is part of what energetic diagnosis is about. It is also about various devices or methods for measuring energies in the body and working with them to both make a diagnosis and then work on treatment. It is very different from the book Toxic, in tone style. But for those of you who think that might be interesting, Have a go.

Ann Shippy, MD

Yes, I appreciate this aspect of your approach because sometimes that intuition about a patient just comes in so strong, and it is such a gift to help bind the path for the patient. Then, if you take a patient’s intuition about what is the next best thing for them and marry that together, it is just such a beautiful collaboration. I love that you are honoring intuition.

Neil Nathan, MD

Thank you. If you want to, I will give you a quick example of that.

Ann Shippy, MD

Yes. That will be great.

Neil Nathan, MD

A couple of weeks ago, one of my mentorees who I know very well, was in Arizona and developed a high fever and got sick. For whatever reason she thought she might have Lyme disease. She wrote to me, asking about what test I should do and how she should go about looking at it. I am just taking in this information and going—that does not sound like Lyme disease. But she tells me she is in Arizona. Whether it is intuition or not, I just said, What about Valley fever? You were in a hotbed for developing a fever there. Whether that is left-brain logical or intuitive, honestly, it was intuitive because I have never treated a case of valley fever in my life. Where did I come up with that? She got tested for a fever. Had it been treated successfully,

Ann Shippy, MD

 Good job.

Neil Nathan, MD

Where does that come from? I trust this brain that I have trained for so long to come up with information. If I just relax and let the information come in, it will spit out ideas, and I have learned to listen to those ideas. Most of the time, and I would submit that I believe that almost all physicians do that but are not comfortable calling it that, so I partly wrote this book to start the dialog so that we can bring that into our teaching of medical students and residents so they could start to honor that sooner on and not shut it off in a little box and go. Well, I cannot talk about that because that is not science. It is human.

Ann Shippy, MD

We are starting to find more and more ways to measure these things and understand them through measurement. It is an exciting time to be in this world that has quantum physics and consciousness, where we are starting to understand that we are more than these physical bodies.

Neil Nathan, MD

We are. 

Ann Shippy, MD

I am so grateful for you taking your time today. You are on quite a mission and impacting so many people, and I had to let people know how to find you.

Neil Nathan, MD

Well, the easy way is my website, which is just neilnathanmd.com, and my upcoming lecture books. That is on the website. There are a whole bunch of old blogs that have gone on for years that are on the website as well. I invite people to learn more, and I hope that this has been helpful for everybody out there

Ann Shippy, MD

Thank you so much. I think it does give hope, which is the bottom line. Even your sick patients have hope for a total recovery, maybe even better than when they started feeling ill.

Neil Nathan, MD

They are very much my bottom-line take-home message: always, every single thing we talked about today is treatable.

Ann Shippy, MD

Well, thank you so much. I hope our paths cross soon.

Neil Nathan, MD

Good. Thank you for having me. I appreciate it.