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Dr. Cook is President and Founder of BioReset® Medical and Medical Advisor of the BioReset® Network. He is a board-certified anesthesiologist with over 20 years of experience in practicing medicine, focusing the last 14 years on functional and regenerative medicine. He graduated from the University of Washington School of Medicine... Read More
Nafysa Parpia, ND has an independent practice at Gordon Medical associates, specializing in the treatment of Lyme disease and other complex chronic illnesses such as autoimmunity, mold toxicity, fibromyalgia, environmental toxicity and gastrointestinal disorders. Her patients with chronic Lyme Disease are typically those who either do not do well with antibiotics, or prefer... Read More
- The difference between a weak immune system and a dysregulated immune system
- How and when to bring peptides on board
- How peptide treatment can open the door to healing for those that have been sick for a very long time
Related Topics
PeptidesMatthew Cook, M.D.
Hi, everybody, it’s Dr. Matt Cook at the tail end of the Peptide Summit, but this is probably gonna be one of my favorite interviews and I was super looking forward to it. And I wanna introduce you all to a super wonderful person and a very amazing doctor. And I think one of the top doctors that when I have questions, this is somebody who I reach out to and ask questions to because I regard her as somebody with great clinical experience in terms of taking care of a lot of patients, with very significant complex on this, we have a similar practice and we think similarly, so, I always love to talk to people who are doing the same type of stuff that I do, hear what they’re doing, learn from them and share what we’re up to. And there’s nobody that I like to do that more so with than Dr. Nafysa Parpia. So here you are, and welcome, and I look forward to talking with you today.
Nafysa Parpia, N.D.
Thank you, Matt. Thank you so much for having me here. I always love to chat with you and learn from you as well. Truly, it’s just always so great to be with you. So, thank you for having me here.
Matthew Cook, M.D.
Thanks, so, as I think about the last couple years, the term that we probably have been talking about for 10 years, but that has been coming up again and again, as a player that’s causing trouble in the world and in our biology and our bodies is immune dysregulation. And the title of my conversation with you is peptide roles in immune dysregulation. So let’s dive into that.
Nafysa Parpia, N.D.
Perfect, thank you. So most of my patients have complex chronic illness. So we’re seeing these patients and I know you are too with these mystery illnesses. Nobody, not too many other doctors can figure out that these patients have been sick for so long. They’ve been to at least five other doctors, some of them have been to 20. And in every system of their body is affected. So we’re talking about chronic infections. Infections and toxins that are causing oxidative stress and immune dysregulation and inflammation throughout the whole system. So, a lot of the times patients come and they may have a diagnosis of infection already, and they want me to treat the infections right away or they’ve come and they’ve had the infections treated and it’s backfired, and they don’t understand why. And so a big piece of what I do is use peptides for immune modulation before I even begin killing, before I even begin detox. And so now with the advent of these peptides, people who are sick, it would take maybe three or five years to treat them, six to 12 months.
Matthew Cook, M.D.
How would you, give me your definition of immune dysregulation and then give me your definition of immune modulation, ’cause those are two terms that I want people really to walk away from and understand.
Nafysa Parpia, N.D.
Absolutely. So, a lot of my patients that I’m sure yours too, on one hand they have a hyperactive immune system. On the other hand, they have a weak immune system. And how can that be at the same time? First of all, I wanna give examples of how I see both of these things happening at once. So my patients have auto immunity, they have mass cell activation syndrome. So that’s an immune system that is overactive. On the other hand, they can’t mount an appropriate immune response to kill off an infection that they should be able to kill off, for example, viruses or tick-borne diseases. So this is happening at once, and there is research that shows that environmental toxins cause this immune dysregulation. And we know that tick-borne diseases in combination with the toxins cause this imbalance. Too much activity, hyperactivity in the wrong direction, and not enough activity.
Matthew Cook, M.D.
Kinda like the immune system got all riled up and it’s throwing a lot of punches, but there’s some friendly fire, you’re hitting people you shouldn’t be hitting. And, but then it’s a little dysfunctional in terms of doing the actual job at hand.
Nafysa Parpia, N.D.
Right, I’m telling my patients actually it’s like having an untrained fighter in the ring–
Matthew Cook, M.D.
Oh, that’s a good one.
Nafysa Parpia, N.D.
That doesn’t know where to throw the punches and the kicks, he’s throwing them all right, but just in the wrong direction. So we train the immune system. Now, Matt, that was something I couldn’t really do before the peptides came along. I mean, I wanted to, of course I wanted to, and I tried, but everything else was not precise enough. This is what I love about the peptides. They’re so tissue specific like nothing else. And so, then we’ve got these peptides that can modulate the immune system in a way that allows me to start detox and killing much faster.
Matthew Cook, M.D.
And how would you define immune modulation in that case?
Nafysa Parpia, N.D.
Yeah, so I’m working on calming mass cell activation syndrome. I’m working on calming on immunity, that first, before I start to work on up-regulating the immune system, so.
Matthew Cook, M.D.
Perfect, so then, let’s talk about, from your perspective, what have been your number one peptides for immune modulation?
Nafysa Parpia, N.D.
Yeah, so of course, BPC-157, it calms down, it brings inflammation down in the system and TB4-FRAG, I notice that calms, now I’ve had patients they’ve come into me and they’ve been on TA1 first. And they said, that was really hard on me. And I say, well, you know what? You already have auto immunity, your immune system is already in overdrive. TA1 is gonna kick that up. So that wasn’t, sure it was the right peptide for you, but at the wrong time. So, timing is critical. So, I like to use TB4-FRAG first along with KPV to help calm down mass cell activation syndrome.
Matthew Cook, M.D.
Which fragment? One to four or the 17 to 23?
Nafysa Parpia, N.D.
The 17.
Matthew Cook, M.D.
Okay, and the 17 to 23 for people listening is also known as TB-500, which is a fragment of thymus and beta-4, it’s smaller, more potent, more effective, more anti-inflammatory than the whole protein and less reactions, including mass cell activation and will help calm down. So then yeah, that’s what I’ve noticed also.
Nafysa Parpia, N.D.
Right, and amlexanox for its mass cell stabilizing properties as well, I like it a lot. So I’m bringing those ones in in the beginning, TB4-FRAG, BBPC-157, KPV and often more than sometimes amlexanox if mass cell is really an issue. And then of course I’m bringing in herbs for mass cell activation syndrome and I’m giving low-dose naltrexone, so I’m giving a lot of other things in addition to the peptides, but I can go lower dose or I don’t have to give the other things as much.
Matthew Cook, M.D.
What herbs will you use for mass cell?
Nafysa Parpia, N.D.
So I like Perilla, and I like the product NeuroProtek by Algonot, because they have a lot of herbs in there that’s gonna help with it all. I like oakley, the quail egg as well. Those are my favorites.
Matthew Cook, M.D.
Yeah, it’s interesting as you’re taking care of people with complex problems, sometimes herbal support can be super helpful. And especially sort of often combinations that will have a diversity of herbs at low dose, I’ve also found to be quite helpful that having both a balancing effect on the immune system and the neurological system, I would say.
Nafysa Parpia, N.D.
Right, but then what I found, Matt, is that the ones who are super, super sensitive, they’re even gonna have a mass cell reaction to the herbs that are supposed to calm mass cells. And I’ve noticed that peptides, you give somebody like that KPV intravenously, they can handle that, but they can’t handle oral herbs.
Matthew Cook, M.D.
What sort of dose would you give?
Nafysa Parpia, N.D.
I start with just 1/8 of a vial in someone like that.
Matthew Cook, M.D.
So like a milligram or two.
Nafysa Parpia, N.D.
Yeah.
Matthew Cook, M.D.
Yeah, I would support that as a great dose. And then what sort of dosing, or do you like for the TB4-FRAG?
Nafysa Parpia, N.D.
So, I’m giving them oral TB4-FRAG, I can start them, I found it four caps twice a day for a few weeks, then I’ll bring it down to three caps twice a day for another four weeks and then ongoing, two caps twice a day. And I have them on these for months.
Matthew Cook, M.D.
So a few milligrams, I had a friend come with horrible GI symptoms and probably some mass cell activation and some C bone, a bunch of stuff. And I was, it just kinda, and they just showed up. And then, it was like a Friday at the end of the day. And then I walked back into my office and I had TB4-FRAG and BPC orally and KPV. As I said, here, just take these and come see me on Monday. And then he came in Monday and was like, oh, I’m a lot better, so it was good one.
Nafysa Parpia, N.D.
These peptides are magic. honestly, I’ve never met any other nutraceuticals or medications even that can have such a specific effect so quickly and toxic.
Matthew Cook, M.D.
And for people listening, KPV is related to MSH, this protein, that’s in the brain. That probably is, and tell me what you think about this idea that MSH is kind of an anti-inflammatory in the brain. And there’s a theory that if we’re exposed to a lot of toxins, particularly mycotoxins that your levels of MSH start to really come down, and then we have a theory that that seems to correlate with a lot of limbic system dysfunction. Then your people start to feel terrible. And then that anti-inflammatory effect of MSH, I think that one of the things that it does is it regulates and manages inflammation and potentially for mass cells, because if you give the KPV, we have found that to be very helpful for mass cell activation. And just for, as you hear this idea, one thing that happens is you get exposed to a toxin. These mass cells come and then they release a bunch of histamine. And then they cause some inflammation as an attempt to create inflammation to deal with whatever they’re responding to. But if they get overly triggered, now you’re getting these inflammatory reactions that are happening, like little fires all over your body to a variety of stimuli.
Nafysa Parpia, N.D.
Absolutely, and the mass cells are, I mean, pretty much everywhere in the body. We’ve got them in the gut, in the muscles, in the bones, in the brain. So these patients who have symptoms everywhere, it’s the mass cells that are flaring in addition with the inflammation, from the infections and the toxins. But speaking of MSH and modeling that, I love melanotan for that.
Matthew Cook, M.D.
Oh, yeah.
Nafysa Parpia, N.D.
Because it modulates everything that’s coming down from the hypothalamus, including hormones. So then, if I start them with melanotan, I don’t have to give ’em as much bio-identical hormone therapy. I do, of course they need it for a foundation of their treatment, but–
Matthew Cook, M.D.
Are you doing melanotan one or two?
Nafysa Parpia, N.D.
One.
Matthew Cook, M.D.
How much are you starting with?
Nafysa Parpia, N.D.
Sorry, melanotan 2. I forget, I think it’s just 2.1 CCs twice a week. How many milligrams, but…
Matthew Cook, M.D.
Melanotan is this interesting peptide that regulates hormonal accesses, it regulates the immune system. It can stimulate your melanocites. So then it kind of, they call it the Barbie doll peptide, ’cause it can make you tan. And then it has a side effect for guys of giving an erection, but it also can have a side effect of some sexual sort of interest in women too.
Nafysa Parpia, N.D.
And there’s so many peptides, well, not so many, but kisspeptin and PT-141, those help so much with sexual health. So, I give that to my patients ’cause so many of these patients who are chronically ill, that part of their life isn’t satisfying.
Matthew Cook, M.D.
Has your experience with, so then of the, in terms of sexual sort of, and so then one idea would be to take melanotan, the side effect of melanotan is it causes a little bit of nausea. And so you have to build up to that. PT-141 is this other peptide that you can do that for men will have the side effect of an erection and it comes centrally. So, you can combine it with Viagra or Cialis and then for women, it will also increase arousal. How has your experiencing been in terms of men and women with PT-141?
Nafysa Parpia, N.D.
So depending on age. So if a guy who’s pretty healthy comes in, I have a range of patients, most of ’em are quite sick, but then I’ve got some people who are coming in for optimization. The guy’s coming in for optimization and he wants some PT, if he has it as needed and he wants to have sex a few times a week and he has it as needed, it can be too much I’ve noticed. So, just lowering how many times a week you might take it, maybe twice a week, for, I’ve got young guys in my patient, who’ve got hormonal levels of an old man because the infections have done that. The metals, the glyphosate, all of that has done that. So, as I’m working on killing infections, detoxing them, I’ve gotta help with their endocrine system. Well, I’m giving you a roundabout answer, I’m giving them kisspeptin to help increase their testosterone. I don’t have to give them chromate anymore for that, which is really nice. So kisspeptin, and then I’ll add in the PT-141. And for them, they can have it as needed, on whatever day they wanna have sex, and same with men who were older than 60, I’ve noticed they can use as much any time.
Matthew Cook, M.D.
How helpful has it been for women?
Nafysa Parpia, N.D.
It’s been pretty helpful. It’s aroused their sexual interest for sure. And some of them report more sensation, so.
Matthew Cook, M.D.
Oh, really?
Nafysa Parpia, N.D.
Yeah, and then of course I also like to give women bio-identical hormone vaginal cream as well with estrogen, progesterone, testosterone, women who have hit menopause, they often need it or they’re perimenopausal they need it. That will also help with sensation and help decrease pain with intercourse. And also same with women who have complex chronic illness, and they have those issues as well as if they’re in menopause, but they shouldn’t be yet.
Matthew Cook, M.D.
And then you do the O-shot or the P-shot?
Nafysa Parpia, N.D.
I’m not doing, oh, the P-shot, we do do it at our office. Dr. Gordon and Dr. Congo does that, and I haven’t done it.
Matthew Cook, M.D.
Okay.
Nafysa Parpia, N.D.
Yeah.
Matthew Cook, M.D.
I think it’s kind of interesting the sexual health conversation with the peptides is to me super interesting, and we have, I’ve experimented with it myself taking it, a bunch of times just to kinda try to understand what was happening. And I find they kick in somewhere between like one and like two or three hours. And then the dose range I typically like is somewhere between one and two milligrams. And so then, sometimes if you do one milligram, it will be like a little bit light, and sometimes if you do two milligrams, it will be like an unbelievable, like, sort of turn on. And it’s interesting that it’s almost like you get on a scale from one to 10 of being sort of “Turned on” it’s like a nine. But then what I think happens is then all of a sudden, you kind of feel okay about yourself and you feel okay about your partner. And then you end up, it kind of drives you into kind of a deeply connected vibe.
Nafysa Parpia, N.D.
Exactly.
Matthew Cook, M.D.
Which would be, a lot of times, I think we take substances to try to drive ourselves like, and who did that? Like almost all of humanity for like the last 3,000 years.
Nafysa Parpia, N.D.
Exactly, Matt.
Matthew Cook, M.D.
But then this is like a, I find it to be an interesting thing because it drives a lot of interest, but then it also you’re totally clear in your thought process.
Nafysa Parpia, N.D.
Exactly, I mean, and there’s so many patients when they’re sick, they’re not being intimate with their partners anymore, and they’re missing that, their partners are missing that. And when we’re able to provide them with that, I mean, their relationships become closer. They feel better about themselves all over. It’s such an important part of our health that I think people aren’t talking about enough.
Matthew Cook, M.D.
Yeah, and that PT-141 probably, it will have a little bit of an effect on melanocites. And so then sometimes I’ve had some Jewish, I have lots of Jewish friends and family. And also lots of Persian friends and family. And so then I’ve noticed PT-141 and melanotan, and then in those populations, and then in many other populations will cause them to tan more quickly. And so then I just remember to be a tiny bit cautious on the melanotan for anyone with slightly darker skin. And then that’s also interestingly, even like for Ashkenazi Jews, that would be normally like almost the same, very light complected. And then I’ve had a few of my friends and I didn’t prescribe it for ’em, but who took relatively high doses of melanotan, and then they tan for like six months.
Nafysa Parpia, N.D.
Jamie Congo, Dr. Congo in our office, he’s been taking melanotan, and he’s got these dark lashes and it actually looks great. It’s a new look, a brand new look on him.
Matthew Cook, M.D.
Maybe that’s a new look, but then that’s a neat conversation because then it’s kind of like, I feel like we were having this conversation about PTSD. This morning I was talking to Dr. McElroy and then Barb overheard us, and she was like, everybody that has complex illness has a little medical PTSD.
Nafysa Parpia, N.D.
Absolutely.
Matthew Cook, M.D.
And I think that that kind of drives us. I think when you have my play acting version of it is that when you’re in PTSD is kind of like you’re running away or hiding a little tiny bit, and then from an emotional perspective or an intimacy perspective, I think that happens. And so then kinda neat that you could do something that would sort of all of a sudden turn that back on and you feel okay about it. And it’s awesome. And I think, and you’ve had good success with this, with some of your patients with complex illness.
Nafysa Parpia, N.D.
Yes.
Matthew Cook, M.D.
Now, the addendum that I will say about this, and then I think it’s fun and I’m also happy to sort of talk about dose and numbers on this one, for people who were totally like, let’s say I took 10 pro football players, you could give ’em all two milligrams of melanotan and probably nothing happens to any of ’em. Now take, I have seen probably 20 or 30% of people with complex illness will react a little bit to PT-141. And so then what I’ll do–
Nafysa Parpia, N.D.
Probably we need less, I’m giving them just not very much.
Matthew Cook, M.D.
Oh, how much are you giving ’em?
Nafysa Parpia, N.D.
Like, 0.1 of a CC, I’ll have them do that just twice a week.
Matthew Cook, M.D.
Yeah, so then this is perfect because I’ve seen some people have headaches from it. And so then what we’ll do is we’ll do like, 100 micrograms, which is a 10th of a milligram or two or 300 micrograms, and then slowly work them into that super low dose. And interestingly melanotan also can cause a nausea. But if for people, if you kind of watch your skin coloration and then started a super low dose and then kind of do grade up on that, and I notice people tend to do well. So, that’s like kind of a helpful tip.
Nafysa Parpia, N.D.
Yeah.
Matthew Cook, M.D.
In terms of sequencing, so then let’s say somebody came to see you and you realized, oh, okay, they’ve got mass cell activation, immune dysregulation, stuff’s outta control. So BPC, TB4-FRAG, KPV, how long does that go? And then what are strategically sort of your next ideas?
Nafysa Parpia, N.D.
Yeah, so I’m gonna have them, I’m actually gonna have them on those peptides throughout the entire treatment.
Matthew Cook, M.D.
Okay, good. And then what was the other one you mentioned?
Nafysa Parpia, N.D.
Amlexanox?
Matthew Cook, M.D.
Oh yeah, what is that?
Nafysa Parpia, N.D.
So, amlexanox it has a, they use it in Japan for conjunctivitis, for bronchial issues, and it has a mass cell stabilizing effect.
Matthew Cook, M.D.
Oh, really? Is that a, and how do you give that.
Nafysa Parpia, N.D.
Injectable.
Matthew Cook, M.D.
Okay.
Nafysa Parpia, N.D.
Yeah. And so it helps a lot with people who have histamine issues. So I’m starting there–
Matthew Cook, M.D.
How much, what dose would you give?
Nafysa Parpia, N.D.
Again, about zero point, I’m forgetting the milligrams, but 0.1 CC. So give it to them three days a week.
Matthew Cook, M.D.
Okay.
Nafysa Parpia, N.D.
Make themselves three days a week.
Matthew Cook, M.D.
Now, before we go on, then if I, I would totally agree on your ideas in terms of mass cell activation. And so let’s say some BPC, some TB4 fragments, and certainly KPV, and then you can do oral KPV, MBPC, you can do injectable, and then you mentioned the IV, which I’m happy that you did, because I think that that’s a game changer. But before we go on, you are deeply knowledgeable about mass cell. Give me your little, if I said, oh, okay, I got a patient, and then they did that and they’re getting some benefit, but they’re still having mass cell activation, and then they tried the amlexanox, like that, so then what would be two or three or four other things that would be on your backup strategy for mass cell activation?
Nafysa Parpia, N.D.
I’m giving them Ketotifen at night.
Matthew Cook, M.D.
Okay.
Nafysa Parpia, N.D.
Starting, if they’re super sensitive, some people get really groggy from Ketotifen in the morning. If that’s the case, they only get 0.5 milligrams at bedtime. Normally I can start people at 1.5 milligrams at bedtime, 30 minutes before bed with a little bit of food, I’m giving them chromaline. So chromaline 100 milligrams, 30 minutes before each meal that stabilizes mass cells. I’ve also noticed it stabilizes mass cells in the genital urinary tract.
Matthew Cook, M.D.
Oh, really?
Nafysa Parpia, N.D.
Yeah, so people who think that they’re having recurrent UTIs, but they’re not, we do the urinalysis, we do the urine culture, they’ve gone to see the urologist. They don’t have IC, some of them, IC meaning interstitial cystitis, for our audience. And some of them do have IC. I give them chromaline, it calms it down, which was really, I was giving them the chromaline for their gut. I wasn’t expecting it to help with IC, but I’ve seen it repeatedly with that.
Matthew Cook, M.D.
Oh, really? Yeah, 100 milligrams before each meal.
Nafysa Parpia, N.D.
Yeah, and then, sorry, go ahead.
Matthew Cook, M.D.
No, go ahead.
Nafysa Parpia, N.D.
Yeah, I was gonna say also Allegra. Starting off sometimes, depending on how sensitive the person is, 60 milligrams, twice a day, 12 hours apart working the way up to 180 milligrams twice a day, 12 hours apart, singular, also five milligrams twice a day.
Matthew Cook, M.D.
Okay, so then this is good. So then, now let’s go back and we’ll go through each one of these, ’cause this is helpful for people to hear what these categories are and how these drugs are working.
Nafysa Parpia, N.D.
So?
Matthew Cook, M.D.
Maybe we’ll start with the chromaline. That chromaline is just a direct mass cell stabilizer, right?
Nafysa Parpia, N.D.
Exactly. For the gut and I believe for the rest of the mucosa, ’cause I see–
Matthew Cook, M.D.
And then Ketotifen?
Nafysa Parpia, N.D.
Mass cell stabilizer.
Matthew Cook, M.D.
Also, do you see any side effects with Ketotifen?
Nafysa Parpia, N.D.
So the one side effect that can be for some people is they’re groggy in the morning. If that’s the case, I just had them dial the dosage down.
Matthew Cook, M.D.
Okay.
Nafysa Parpia, N.D.
Right, a lot of times hydroxyzine is gonna work a lot for people just to low dose, 25 milligrams, four times a day. These are for the people who are highly highly, their mass cells are highly, they’re on a higher trigger.
Matthew Cook, M.D.
And the mechanism on that is?
Nafysa Parpia, N.D.
I think it is a mass cell stabilizer but I can’t remember.
Matthew Cook, M.D.
And then there’s a whole bunch of medications that are basically antihistamine type of medications that people would use.
Nafysa Parpia, N.D.
Allegra.
Matthew Cook, M.D.
Allegra.
Nafysa Parpia, N.D.
Sometimes, Benadryl IV for those patients who are super sensitive before we give them the rest of their IV therapies, we give them a Benadryl IV.
Matthew Cook, M.D.
How much will you give ’em?
Nafysa Parpia, N.D.
25.
Matthew Cook, M.D.
I have also found and Benadryl’s kind of sedating, but that it can be helpful along those lines, and then the nice thing is, and I also have a fairly similar practice, Nafysa, in terms of IV therapy, because I’m a wannabe naturopath.
Nafysa Parpia, N.D.
Not very many naturopath doctors do it the way I do it too, though. Who trained me was is Dr. Isaac Eliaz.
Matthew Cook, M.D.
Oh, so then we have to have a shout out to Dr. Isaac Eliaz, ’cause I have a newfound friend in Dr. Eliaz because basically about, I dunno, about 200 different accounts times Nafysa told me, oh, Isaac Eliaz this, Isaac Eliaz that. And so then we were doing this Peptide Summit, and so then, because of your strong recommendation, I just cold called him to see if he would come on the podcast. And then we had so much fun that we ended up doing a second one.
Nafysa Parpia, N.D.
That’s so great.
Matthew Cook, M.D.
And so then he is, basically, I think the greatest doctor of his generation. I mean, it’s just crazy how amazing and how spiritually and intellectually and clinically deep he is, it just blew me away.
Nafysa Parpia, N.D.
Yes, I just love him. He mentored me and he was like, I consider him like a father in medicine for me. And I just learned so much.
Matthew Cook, M.D.
And so then from a, just, this would be interesting for people to hear, because to understand kind of IV therapy and how people think about, where would you say his thought process or learning from IV therapy came from?
Nafysa Parpia, N.D.
I really think that he took what he learned from Chinese medicine and integrative oncology and created it for his own, which is–
Matthew Cook, M.D.
But then, a lot of people like what I do and what you do, I think are somewhat derivative of the type of stuff that he developed and created.
Nafysa Parpia, N.D.
Right, which is how you, every time you kill an infection, you detox the person on the same day with an IV that’s compatible, with the killing agent.
Matthew Cook, M.D.
And so, there’s, that takes us back to at some level, maybe like a triangle of that, you have to kill if there’s infections, you’ve got to detox what you killed and then the inflammation that’s happening as a result of the infection. But then, in parallel to that, then that causes there to be a little bit of inflammatory and immune stress. And so then you’ve gotta regulate the hospital.
Nafysa Parpia, N.D.
Yes, and so this is such an important point because before peptides came along, and before we understood mass cell activation syndrome, I went straight to detox before I would kill, because I know every time I kill I’m releasing bio-toxins, there’s byproducts of dying cells and dying microbes. And there’s inflammatory cytokines that are released. So now our patients are already toxic. They’re already super inflamed. So if I start to kill infection, somebody who’s this inflamed, other things just get more inflamed. So that killing is gonna backfire. So what did I do first? I detox them first. I brought the inflammation down first as best as I could. And then I’d start to kill and detox at the same time. Then I learned more about mass cell activation syndrome. I treated them for MCAS, for those patients who don’t know what MCAS stands for, it stands for mass cell activation syndrome. So it helped, if I treated them with MCAS first, boy, that made them less, what can I say, sensitive to detoxification in killing, due to the inflammation that comes about as a result. Then come along peptides, a few years ago, I started to use them. And now if I put them on top of the rest of the treatment, everything else is smoother. Everything else is faster.
Matthew Cook, M.D.
And I would say, and then sometimes they’re gonna be synergistic. For example, like, I was teaching at the International Peptide Association, IPA. I taught at the a forum IPA meeting for four days, and then somebody was giving a lecture on KPV and that it actually has some antimicrobial effects in addition to sort of regulating and calming that immune system.
Nafysa Parpia, N.D.
Right, but I’ve noticed that it hasn’t bothered my patients.
Matthew Cook, M.D.
No, yeah, and you know what, it’s kinda interesting when you think about mass cell activation syndrome, ’cause I remember vividly when we went to the first lecture at ILADS years ago with Eric, When we were at the lecture, when they kind of unveiled mass cell activation, remember that?
Nafysa Parpia, N.D.
Right, when was that, Matt? Like four years ago?
Matthew Cook, M.D.
Yeah, it was like four years ago, it was crazy. That seems like it was like last week. But it’s interesting, I think, because as you think about something like complex illness and it’s kinda interesting to take care of people with long COVID because long COVID basically, the immune system got stressed out, it’s getting all riled up. There are inflammatory cytokines, aspects of the immune system are a little stressed out, such as mass cells. And, but the nice thing is it’s been going on for six months, so we’ll see a lot of this, and generally having good experiences, getting people back the majority of the time relatively quickly, versus lime and mold and complex illness, a lot of times we run into people where they’ve been dealing with that for 15 years.
Nafysa Parpia, N.D.
Exactly, yeah.
Matthew Cook, M.D.
And so then their bodies are so stressed out that it’s, and I’d love the kind of your thoughts on this, their bodies are so stressed out that often anything that you do can really throw them sideways.
Nafysa Parpia, N.D.
Exactly.
Matthew Cook, M.D.
And so then, I would say, my whole journey and I think your whole journey has been to basically tread as lightly into those water as you possibly can because they’re dangerous a little bit. But then finding strategies to begin to kind of help them, and then I would say, the peptides have been probably our most successful strategy that we’ve found, particularly at a 1.0 because just of starting to calm down things and kind of reset the experience.
Nafysa Parpia, N.D.
Right, I mean, they’ve really made such a difference in my practice, I can’t even tell you. Really the people that would take years, it could take a year, they’re still coming to the clinic. They’re still coming and staying for six months or coming back and forth every couple months, staying for a couple weeks, getting all the IVs, getting everything I would’ve given them anyways, whether it’s IV antibiotics or oxidative therapies or detox IVs, they’re doing all of it. But I add in the peptides and it’s faster.
Matthew Cook, M.D.
What are the other peptides that you have found to be super helpful from an intravenous perspective?
Nafysa Parpia, N.D.
BPC-157 has.
Matthew Cook, M.D.
Okay, what sort of dose?
Nafysa Parpia, N.D.
So I’ve gone up to a vial.
Matthew Cook, M.D.
Okay.
Nafysa Parpia, N.D.
I haven’t gone higher, how about you?
Matthew Cook, M.D.
I will go low dose typically for BPC-157. As you, and so then what would low dose be for me in the ballpark of 500 micrograms to like a milligram. For a while I was doing like two milligrams that I’m kind of backed down to one milligram versus like you give KPV and people just feel great and it doesn’t—
Nafysa Parpia, N.D.
‘Cause BPC can really rev people up.
Matthew Cook, M.D.
Yes, and I will say that I’ve seen some people have some mass cell activation and some sort of, and so then my general thought process is I start real low with BPC-157 IV.
Nafysa Parpia, N.D.
And then I work my way up to the one.
Matthew Cook, M.D.
Kinda work my way up, and, but then these are, it’s interesting, like you could think of these peptides were basically pinching some subcutaneous tissue and injecting them in and then they’re gonna be slowly absorbed. Now, what else do we inject into subcutaneous tissue? NAD. And then NAD tends to go also very well IV and there’s gonna be tricks and ways to kind of manage and do that. And then in general, I found that the peptides also will work very well, but then I’ll also sort of think about how big they are. And so then like small peptides, nobody reacts to. And so like, if you get GHK without the copper is three amino acids. And so, it’s kind of like a bio regulator. And so then that one people will do good with IV and can do at bed.
Nafysa Parpia, N.D.
Yeah, I love GHK with the copper for using, for helping with opening the detox pathways. ‘Cause we need that copper to help open up the pathways, so.
Matthew Cook, M.D.
Oh, good, so then let’s go into the detox road. So then if you were gonna do GHK with copper, where would you inject it? And then how much would you use?
Nafysa Parpia, N.D.
So, subcutaneous, just under the skin like that in the abdomen. And again, I go low doses twice a week, 0.1, obviously.
Matthew Cook, M.D.
There will be moderate amount of people that will, GHKs with copper is an amazing peptide and it’s really good for connective tissue and collagen and the copper is good for detox. And I think it’s a great way to get the copper, it can sting a moderate amount, but then that’s normal and it goes away. So if that happens to you, don’t worry about that. And then there are more and more people doing interesting protocols. There’s a great doctor that teaches in the IPA Certification that I was talking to this weekend and she will mix GHK and peptides in her PRP.
Nafysa Parpia, N.D.
That makes a lot of sense.
Matthew Cook, M.D.
So then, that’s just a little cool idea to kind of throw out that we’re in a interesting evolution of what’s happening in regenerative medicine, in terms of our ability to do things and our ability to kind turn the healing potential up often with some of the, what I would regard as kind of low cost therapies, which is kinda amazing because now suddenly, we’re taking a Toyota and turning it into a Ferrari.
Nafysa Parpia, N.D.
We are, and I love that, Matt.
Matthew Cook, M.D.
So then if I said, and then, well, I’ll just see what you say, and then I’m gonna ask you more questions, but talk to me, take me top to bottom, talk to me about detox for complex illness. How do you think about it? What are the top few things you use? What are the IVs you use? What are the supplements? What are the herbs? What are the peptides?
Nafysa Parpia, N.D.
Yeah, okay, this is very exciting. So, this could be a really long conversation. I could talk to you about this for like 10 hours, but I will like–
Matthew Cook, M.D.
I’ll cut you off in one. I’m gonna cut you off in an hour, so go.
Nafysa Parpia, N.D.
Okay, so, first of all, I like to do something that I call pretox. A lot of patients just aren’t ready for detox, why? They might have elevated liver enzymes. They might have recurring UTIs. They might have interstitial cystitis or they’re constipated, or they have mal-absorptive issues. So now if you try to pull toxins out of cells with this patient, those toxins are just gonna recirculate. And so I have to set the stage for them to be ready to detox. A lot of people who have SIBO, they don’t do well with the defiles for pulling out heavy metals. So I have to treat the SIBO first.
Matthew Cook, M.D.
That’s small intestinal bacterial overgrowth.
Nafysa Parpia, N.D.
Right. So, there’s a lot of work that has to be done for my patients before they’re ready for detox. Now what’s interesting is so many, I used to be a yoga instructor. I love yoga, and I know a lot of yoga studios might say, come to your detox or the local grocery co-op and that’s just not, it’s not personalized at all. And so this has to be, in my mind detox has be personalized. Is the person ready for it? If not, let’s get them ready. And so I’ll evaluate all these things by labs, and then go ahead.
Matthew Cook, M.D.
What are your favorite labs for detox or for kind of assessing toxicity?
Nafysa Parpia, N.D.
Yeah, so let’s talk about metals first. I like to look at metals unprovoked and provoked first. So to keep our medical licenses intact, we have to look at unprovoked as well. That’s, this hands down, we have to do that. Not only that, but it’s gonna give a us the information we need as in is the patient currently exposed? So I’m looking at blood and urine.
Matthew Cook, M.D.
So then, just for people to hear what that means is, is we could take some urine, just wake up and go to the bathroom and then catch some urine, and then another thing that we could do is we could take a chelating agent, which would help pull some metals out of the body and then catch some urine after that. And so the second one is called a provoked. And so then, the second one is gonna be trying to get a sense of what are the total body stores? And the first one is gonna be trying to say, is there a such an amount of toxins or metals in the blood, in the body that even without any provocation, we’ll see it? And so then we are looking at those two things.
Nafysa Parpia, N.D.
And so it is so important to look at both because the first one tells us, is there something acute that’s happening? Are you eating too much fish? Is it in your drinking water? Is it in your home somewhere? The second one is what’s the body burden? What’s in the cells? So metals accumulate in the cells of our organs. So our kidneys, our liver, even our thyroid. And so when we’re provoking, we’re getting a sense of the burden in the cells.
Matthew Cook, M.D.
Okay, perfect. So then, we’ll go category by category. So then this would be category one, and so then we go, oh my God, there’s some metals, and let’s say there’s some mercury in that. So, what would be kinda, do you prefer IV chelation or oral chelation or both? And how would you think about that?
Nafysa Parpia, N.D.
So I do prefer IV. It’s gonna be faster, it’s more efficacious. Now, oral though, can be very helpful because fungus and parasites sequester metals. And so when we’re killing those bugs, we can give somebody oral to mop up the metals that’s spill as we–
Matthew Cook, M.D.
What are your favorite things to use for oral chelation?
Nafysa Parpia, N.D.
So, if I’m gonna use a medication, then DMSA. And I don’t know of any or herbs that chelate as strong as these medications, but I’ve always got herbs on board. I’m supporting the organs of elimination, the kidney, the liver, the lymph with herbs, I’m tonifying those organs, and I’m also using herbs to tap on them, if you will, to say, okay, it’s time to detox. It’s gonna make those organs detox, find more. I’ve actually formulated herbal tinctures for that. And binders, of course, to bind up the metal and flush them out of the system.
Matthew Cook, M.D.
We interviewed Chris Shade, who’s a wealth of information on this. And so then he has a thing that he does called push catch. And so then what he’ll do is give someone some digestive binders, which kind of turns on the liver on the gallbladder and kind of encourages that to squeeze and push any toxins that are, or waste products out. And then he’ll have people take charcoal, and then if they have metals, he’ll take, he has a powder called IMD, intestinal metal detox, and then–
Nafysa Parpia, N.D.
So I do the same thing.
Matthew Cook, M.D.
Okay.
Nafysa Parpia, N.D.
Push and catch. So I’m pushing, I’m having people take these herbs to push.
Matthew Cook, M.D.
Yes.
Nafysa Parpia, N.D.
Catching, I love Dr. Eliaz’s products. I like Chris Shade’s as well, but I tend to use PectaSol, which is modified citrus pectin. ‘Cause Dr. Eliaz has done a lot of research to show that it binds inflammatory cytokines.
Matthew Cook, M.D.
100%. And has this effect on galectin-3, which is… And then will you combine his product with charcoal or just will you–
Nafysa Parpia, N.D.
Sure. Yep, I will.
Matthew Cook, M.D.
Or, and so then I’m deeply a fan of his also, and I kinda like them both. And so then within, I think most patients with a little toxicity can benefit from some of these concepts of some binding, some pushing in terms of toxicity. And if you say, oh, okay, what doctors have been doing this? Doctors have been using herbs probably for a couple 1,000 years to do that in fact task.
Nafysa Parpia, N.D.
Exactly. And thing is our bodies are set up for detoxification, that’s what our liver, our kidneys, our skin, our gut does. But our world is so toxic now, we haven’t evolved as fast as our world has become toxic to be able to handle this. So now I am giving patients a lot more than what patients needed even 20 years ago. This is only IVs come in, phosphatidylcholine IV, glutathione, the IVs to pull the metals out.
Matthew Cook, M.D.
Yeah, that is one of my favorite all time IVs that phosphatidylcholine, and then we’ll do it, now if, this one’s an interesting one for, ’cause the phosphatidylcholine is in dextros and then all of our other IVs are in saline. Do you like to do the phosphatidylcholine and then all the other stuff, or do you do all the other stuff and then the phosphatidylcholine at the end?
Nafysa Parpia, N.D.
You know what? I’m going between both. So I’m assessing, okay, so I’m looking, let’s go back to your first question, ’cause, your first question of what are you testing for?
Matthew Cook, M.D.
Oh, perfect.
Nafysa Parpia, N.D.
Regards to toxins. Because that ties in to what IVs I’m using and when. Yeah, so I’m also looking for glyphosate.
Matthew Cook, M.D.
Are you doing that with the GPL? So then that’s a pesticide that’s important to look at 100%.
Nafysa Parpia, N.D.
I’m having them provoke with two grams of glutathione IV. And then they’ll catch their first year in right after. I’ve had them do unprovoked and provoked as well for people who want that data, and they have the money to spend on it. It’s great to do both if you can.
Matthew Cook, M.D.
I should totally support, that’s a great idea. That’s a really good one.
Nafysa Parpia, N.D.
Yeah, so I’m looking for, I’m using the Great Plains Lab, looking for a glyphosate, mycotoxins in those people that’s indicated and their tox panel looking for chemicals, other chemicals, solvents and pesticides like that.
Matthew Cook, M.D.
If you have somebody who you think might be a person that got exposed to mycotoxins, are you doing antibody testing and urine testing?
Nafysa Parpia, N.D.
I am. So I’m looking at their mold IgG allergens, ’cause I wanna know, do you have an allergy to the mold spores themselves. Allergy doctors like to look at just IgE, and so the patient has gone to the allergist, IgE is always zero, and the patient says I don’t have a mold allergy, and I say, wait a second, let’s look at your IgGs, because the IgEs are just looking at the mucosal tissues less–
Matthew Cook, M.D.
Is that with Andrew Campbell’s Test Company?
Nafysa Parpia, N.D.
No, that’s a different one. We’ll do that too. I look at MyMyco to look at the allergens, the IgGs to their mycotoxins. In fact, in order to use that one more than the Great Plains, because when I use Andrew Campbell’s, the MyMyco, not only I’m I seeing levels of mycotoxin, but I’m also seeing if they’re having an allergic response to like–
Matthew Cook, M.D.
No, I think he’s great. I’m a fan.
Nafysa Parpia, N.D.
Yeah, but then just on LabCorp, you can get mold IgGs to look at the allergic, not to the mycotoxin but to the mold itself. I’m thinking, okay, do you have an allergy to the mold itself? Do you have a high mycotoxin load and are you allergic to the mycotoxins? Do you have an exposure? And so, I’m having them start with an AMI test from environ bios, ’cause I like the writeup from environ bio mix for their AMI test at home.
Matthew Cook, M.D.
That’s a mold test for home. So then that’s a good one, ’cause imagine you might be sitting at home having some brain fog, difficulty concentrating and fatigue and low energy and some of these classic symptoms. And so then you’d come to Nafysa and then she would kind of start to talk to you and then you would go, oh, this person might have mold. And so then looking to see if the mold, in terms of antibodies, looking to see if there’s mycotoxin in the urine and then doing some testing at home. So then basically this is all kind of investigative work of trying to figure out of these super common symptoms that lots of people have. There’s a handful of different things could be a tick-borne infection, could be mold, could be chronic viral, could be long COVID.
Nafysa Parpia, N.D.
It’s all of these for our patients. And let’s go back to long COVID. What I’ve done is tested their other infections. Very, very often, I’m using a T-cell test, I’m using Infectolab. I’m seeing that there is another infection that’s active and that when we press on those infections, when we treat those infections along with everything else we’re doing for long COVID, the person does get better. So it’s not just, oh, there’s inflammation only from COVID, no, there’s very often Epstein-Barr virus or cytomegalovirus, often mycoplasma, simultaneously. And the patient have no idea.
Matthew Cook, M.D.
But then, that’s 100%. So, Infectolab is this test that looks to see what your T-cells reactivity is. And so you might not even be making antibodies to Borrelia which is Lyme disease, but then you could have long COVID and then all of a sudden, all kinds of things happen, and then we do a test and we show your T-cells are having a dog fight with Borrelia. And so then that kind of helps us orient, oh, okay, so then that case, we would say probably maybe this person maybe had Lyme in the background.
Nafysa Parpia, N.D.
Exactly, exactly. And I tell them, so this was a subclinical infection, meaning your immune system was able to handle Lyme and it should be able to. So now we’re going back to that immune modulation, their system was able to handle that infection that they should hands down be able to, then along comes COVID and the flare of inflammatory cytokines, and now that stirs the infection that was just under the surface that patient was able to handle and now they can’t. So they think it’s just long COVID, but it’s not, it’s the waking up of dormant infections that they didn’t know they had.
Matthew Cook, M.D.
Go ahead.
Nafysa Parpia, N.D.
Oh, that they didn’t even know they had to begin with.
Matthew Cook, M.D.
Right, and now this is a crucially important concept to kind of stay on for a sec, ’cause I think maybe this just wasn’t quite in the consciousness. And I have to admit like five years ago, I don’t even think that I really understood this to this extent. And I think, hanging out with you and Eric, Gordon and all of our kind of friends has educated me, but this idea that a lot of us have been exposed to infections. A high percentage of the sexually active people have been exposed to herpes.
Nafysa Parpia, N.D.
Right.
Matthew Cook, M.D.
Except, they’re not having a herpes outbreak, but then even if you’re not having a herpes outbreak, if you get a big stress, suddenly herpes can come out. And then in the same way, if someone has a big immune stress, like COVID, then these underlying things could be Epstein-Barr, which comes from mono or could be Lyme disease or could be mold. These things can kind of come out.
Nafysa Parpia, N.D.
Right.
Matthew Cook, M.D.
But then now you’re going through a beautiful process of talking to them, doing diagnostic testing and trying to sort out what those things are, I guess.
Nafysa Parpia, N.D.
Right, and there’s so many of those things, it’s never just one toxin, or never just one bug. So now back to toxins, all of this weaves in together, that’s why we’re kind of going off to talk about immune modulation and bugs and coming back to toxin, ’cause they’re all–
Matthew Cook, M.D.
The same. All similar, yeah. But anyway, go ahead. Back to toxins.
Nafysa Parpia, N.D.
So then I’m testing the other toxin, I’m testing the chemicals, and then I’m treating. So now back to the question you asked me, well, what are you using first? The detox, I’m using it all. I’m going to back and forth, I’m looking at the different layers. Well, how bad is the mercury? How bad is the lead or the arsenic, whatever the metal is? It’s never just one. And then what about the glyphosate? Some people, their glyphosate is through the roof. Like I’ve never seen before. Typically I’m gonna try and bring their glyphosate down.
Matthew Cook, M.D.
But the best thing to detox glyphosate?
Nafysa Parpia, N.D.
So IV, phosphatidylcholine, glutathione, I’m giving, oh, I’m always giving them minerals and amino acids because they’re co-factors for detoxification. So I’m giving them that. And then of course, Isaac Eliaz, Dr. Eliaz’s glycol plant is a great oral product to help with that. But so for steps, for detox, I’m looking at their minerals, I’m looking at their amino acid status on the labs because I know that if those are low, then I could give them chelating agents, I could give them phosphatidylcholine IVs, all of that till the cows come home. But they’re just gonna keep recirculating those toxins unless the minerals and the amino acids are in good standing. So I’m getting–
Matthew Cook, M.D.
Every two weeks at a minimum I do an IV and I always do minerals and I find it to be really kind of awesome.
Nafysa Parpia, N.D.
It’s so awesome. Oh, I have an IV formula. We call it the anti-anxiety formula. It’s minerals, I’ll share the formula with you later, if you don’t have it already, amino acids, minerals, glycine, toling, some vitamin C in it and oh, it chills the patient out. And I tell them, I’m giving this to you, not only because you’re a little bit anxious, but also because it’s giving you the co-factors for detoxification. So I love this IV because it’s so well rounded, and the patients very often request that one.
Matthew Cook, M.D.
And I would say, if I went back to my thought process, like 15 years ago, and then I was dealing with anxiety every day, because I was like doing anesthesia for people. I had a very brick and mortar idea of what anxiety was and that for some reason maybe someone had anxiety because of some thought process, or maybe because of some susceptibility or because they were, got addicted to Benzos, but that was basically my three ideas. But that would be about it. Now, maybe, and you can weigh in on this then we’ll go back. But I think it’s super embarrassed saying that now I think, oh, maybe they have a tick-borne infection, maybe they’ve got some mycotoxins, maybe they’ve got some systemic inflammation, but maybe they’re weak on their co-factors and they just can’t detox.
Nafysa Parpia, N.D.
Nobody taught us this in medical school. We had to learn this with patients and mentors, of course. And inflammatory cytokines cross the blood brain barrier, bugs cross the blood brain barrier now, every time, and I’m like you, when I first came out of medical school, I thought that anxiety was usually about an emotional thing. Oh, they’re having a hard time at home, or oh, they had a lot of abuse in their lives or bad marriage. They need therapy. And so it’s very common that that goes on too, but I’m never not thinking about a bug anymore or toxins.
Matthew Cook, M.D.
And then, but within that, then this has been kind of one of borderline my favorite things to sort of, that I’ve become aware of. And then even kind of personally with my friends and family and stuff like that, because now if I see somebody anxious or upset or this or that, then a lot of times I just start to wonder, oh, I wonder what’s going on, maybe there’s something like, something in one of these categories. And so then, I kind of give them a moregan, as a result of that, because I’m sort of of like, oh, okay, if to anxious behavior makes me think that there’s something on an infection or like immune stress. And then as a result, I have a more lighthearted approach to everybody which has super low stress for me, and then if I ever have any stress, I begin to wonder, oh, I wonder if anything’s going on. And then interestingly, now we have all of these things, you know what I mean? Like there’s a peptide, there’s an anti-infection called And so then like, and I will notice if people are stress sometimes just doing something like thymus and alpha 1 and LL 37, or just LL 37 or immune support or anything in any of these categories. And then you realize in terms of complex illness, the impact that it has on the emotional system is a 10 and vice versa, right?
Nafysa Parpia, N.D.
Yes, our patients suffer from so much anxiety. And then they’re told from other doctors, or from family members, just pull yourself together, things like, what’s wrong with you? Go get some therapy. You’ve been anxious for too long, or you’re making this up, you’re creating your problems. And actually that’s far from the truth. People are gonna be anxious when they’re sick like this. And they’ve got inflammatory cytokines crossing the blood brain barrier and infections crossing the blood brain barrier. Mycotoxins also crossing the blood brain barrier. It’s gonna cause anxiety.
Matthew Cook, M.D.
But so then, what my teaching for people is, oh, guess what? Probably part of how you feel is just because of your biochemistry. And then I kind of get people to have a slightly lighthearted approach towards it because I say, oh, okay, well, we’re just gonna kind of try to work on potentially doing some things that might treat the cause of that. And so then now I’m doing something with an eye towards seeing how it feels. And now I’m not, if you can kind of get into that psychology, then now you’re not overwhelmed by the fact that you have anxiety because you’re doing something that begins to impact.
Nafysa Parpia, N.D.
Right, and the patient begins to even feel better about themselves. They boost their confidence to know that this is something that’s coming from the outside, it’s not–
Matthew Cook, M.D.
Right, yeah, the whole journey is to help people feel better about themselves.
Nafysa Parpia, N.D.
Yes.
Matthew Cook, M.D.
We kinda, it got almost back to kind of where we started on sexual stuff. But it’s also just like in a way we’re out trying to win hearts and minds and kind of help people basically realize, oh, I’m gonna be okay, we’re gonna get better.
Nafysa Parpia, N.D.
Yes, and they do, and they are okay.
Matthew Cook, M.D.
Yeah.
Nafysa Parpia, N.D.
They do a little bit of work and we’re there for them.
Matthew Cook, M.D.
Yeah, but then in terms of, did we cover detox in terms of, and so then in terms of your detox, rather, we’ve got binders, we’ve got chelation if there’s metals and in terms of mycotoxins, just since that’s a topic that you know a lot about, what are your favorite binders?
Nafysa Parpia, N.D.
So again, I’ve noticed that PectaSol is amazing back to Dr. Eliaz’s, I love that. I also like to use Takesumi Supreme for jungle and sometimes the patient does need colestyramine. So I’ll give them 500 milligrams, three times a day, or 1,000 in the morning and 500 at night, just low dose, that really helps with many–
Matthew Cook, M.D.
You use Welchol?
Nafysa Parpia, N.D.
Yeah, I use colestyramine more.
Matthew Cook, M.D.
It’s so interesting to me, there’s so many, as many Lyme doctors, good Lyme doctors says there are, there’s that many protocols.
Nafysa Parpia, N.D.
Exactly.
Matthew Cook, M.D.
But then I would be very similar to you, we’ll use Welchol, sometimes we’ll use colestyramine, sometimes we’ll use Takesumi Supreme, a lot of times we’ll use Chris Shade’s charcoal that we like a lot, the ultra binder. And then we always use a modified citrus pectin. And I like that it goes well with everything. And then Isaac told me that you can take it with food even, so then that, so it kind of, it’s like a two for one, ’cause it’s an anti-inflammatory binder.
Nafysa Parpia, N.D.
Right, that’s why I love it.
Matthew Cook, M.D.
Yeah. In terms of up-regulating detox pathways, what are your top three ideas?
Nafysa Parpia, N.D.
So definitely I’m giving them the co-factors, you know what I’m doing? I’m also looking at their methylation panel by health diagnostics.
Matthew Cook, M.D.
Oh good.
Nafysa Parpia, N.D.
Right, because I wanna see if the glutathione is oxidized or reduced because I know if I give a patient the end product of methylation glutathione, and I give them methylated B vitamins, that’s gonna up-regulate their detox system. But some people aren’t ready for glutathione, or they’re not ready for methylated B vitamins. And that glutathione panel is gonna give me the sense of that, do I need to work on co-factor first? Do I need to gain a little bit of SME first? And then once I set the stage, if it needs to be set for my patients, it usually needs to be set. Then I’ll give them glutathione, and B vitamins to up-regulate it. And also my herb formulations will, the ones that are the push herbs.
Matthew Cook, M.D.
Are the push herbs, yeah. And then I always liked, you shared this one with me a long time ago, but your, I thought it was, I love the concept of it from a detox perspective, is your lymphatic drainage IV.
Nafysa Parpia, N.D.
Yes, that’s right, yes–
Matthew Cook, M.D.
Tell more about that one.
Nafysa Parpia, N.D.
Yeah, so it has some toling in it. It has some lymphomyosot, hevacomp, solidago, mucosa in it, which are German homeopathic drainage remedies. Excuse me, just one sec, little bit of magnesium, little bit of vitamin C as well. And I now met a lymphatic drainage specialist who will go to my patient’s homes.
Matthew Cook, M.D.
Oh really? Oh, that’s amazing.
Nafysa Parpia, N.D.
Yes, but she lives in the North Bay. So she’ll come to people who are closer to this side. So if you have any patients closer to this side.
Matthew Cook, M.D.
Oh yeah. The lymphatic drainage is just one of the great things in the world. Basically they do these real light massages that kind of help to move basically lymph and turn on lymph and drain.
Nafysa Parpia, N.D.
And dry skin brushing, and hot and cold contrast showers. So using all these old school naturopathic techniques, which I think worked so well back in the day on their own when people weren’t as toxic now–
Matthew Cook, M.D.
Are you doing, do you do hot and cold plunge?
Nafysa Parpia, N.D.
Oh, myself, I need to work up to that, I can.
Matthew Cook, M.D.
Okay, so I’m gonna sell you my list, I’m gonna sell you so hard on this.
Nafysa Parpia, N.D.
I know I need it, Matt.
Matthew Cook, M.D.
It can change you life.
Nafysa Parpia, N.D.
I know.
Matthew Cook, M.D.
Do you know what? There’s nobody that I ever met in my life that avoids cold like Barb. She doesn’t have much fat on her. And so then she was always cold. And so then, we got a cold plunge about a year ago and I’d been into it before, but then there’s probably been like two days that I didn’t cold plunge. And what happens is, is kinda like fasting. It’s kinda like fasting, like when you first fast, all of a sudden, you think I’m so hungry, I’m definitely gonna die right now, and I’m definitely gonna 100% not be alive in like three, four seconds. And then all of a sudden, next thing you know, you’re like, oh, I’m fine, I’m not even hungry anymore. I was like, and so that, and then once you kind of go through that and start to fast for a few days, next thing like now, I could just like stop eating and then I could not eat for a couple days. Same thing with cold, you get into the cold, you think I’m definitely gonna die right away. And then when you’re breathing and then you, I start, I do these breathing exercises and then next thing you know, I sit in there for like six or seven minutes, it’s crazy.
Nafysa Parpia, N.D.
That’s great. Eric can do that too. He just goes right in.
Matthew Cook, M.D.
I’m gonna get you into it. I promise you, I’m gonna get you in, this could change your life. And we like it for patients. One thing that I see on your list, that is, I think, in all of these topics, in terms of detox, in terms of immune and in terms of problems, the area that takes a hit a lot of times is the brain in terms of neuro-inflammation. Thoughts about that with respect to peptides and maybe any general thoughts?
Nafysa Parpia, N.D.
Yeah, what I’ve noticed is that my patients who still have a high infectious load, if I give them the neuro peptides, doesn’t work yet. So I have to clean them up. It’s like, this is something I know I need to remove the insults first, kind of like treating the mitochondria as well. So I remove the insults. The thing is when you remove insults, the patients are often still inflamed because with chronic illness, you can remove the inciting event, but the system is already set up. The inciting event is already set up, the neuro-inflammation it’s already set up, the inflammatory cytokines and the mass cell activation syndrome. So, I can pull out the triggers and the system is still stuck. This are danger response. Stuck in inflammation, that’s CDR1. And so when I come in with the neuro-peptides, after it really helps. And I had to learn it the hard way. If I gave somebody C-rank or subolycine first, it did nothing. So it’s like, okay, let’s wait. And now it works. I like to give people RG3, it’s not a peptide, the synapsin, but that really helps with the microglial inflammation.
Matthew Cook, M.D.
This is a nasal spray, and then that has?
Nafysa Parpia, N.D.
RG3, yeah. And then, so C-rank is gonna have to elevate the BDNF. So synapsins detox, it’s liver protective. some of the toxins that are latched onto the receptor sites.
Matthew Cook, M.D.
And are you using C-max also?
Nafysa Parpia, N.D.
Yeah, but that was one that I really, really wanted to work in the beginning with my patients, and I noticed, sorry, no. After it will, definitely, it’s amazing for after I’ve killed off infections.
Matthew Cook, M.D.
How long in terms of treating, working and killing it, would that be mostly with antibiotic type of approaches?
Nafysa Parpia, N.D.
So sometimes I have to give people IV antibiotics. Most of my patients, they don’t even need it. So, maybe like 15% of the patients will need that, and then.
Matthew Cook, M.D.
And so then when you’re working and killing, then you’re mainly thinking about oxidative therapies in terms of–
Nafysa Parpia, N.D.
Therapies, and I hate to give people oral antibiotics for a long time. I don’t do that. I’d rather give them IV antibiotics for a longer time because it bypasses the gut. People are walking around with trashed guts from being on oral antibiotics for years. And so at Gordon Medical, if someone is using IV antibiotics, it’s usually just six weeks. They need it for, we’ll give them for six weeks. Maybe they’ll take a break for a month. If they need another six weeks, we can do that, it’s faster. Always they’re getting detox at the same time on the same day, I think you asked me this as well. So, if we’re giving IV antibiotic, I’m also giving phosphatidylcholine or glutathione same day after.
Matthew Cook, M.D.
Okay, so then this is I think also helpful to hear for people that imagine there’s a spectrum of infection, and so there might be outta control infection over here that really requires antibiotics. But then what percentage of that? And then I’d like to hear you say that, because we would be similar, there’s could be a small percentage of our patients that we would do antibiotics for, for complex illness. The vast majority have immune dysregulation and neurological inflammation and inflammatory cytokines. And they’re in kind of a smoldering cytokine type of storm.
Nafysa Parpia, N.D.
Exactly, we calm that down. Oftentimes they don’t need IV antibiotics, not at all. Just some herbs to kill off Lyme is often, that does it.
Matthew Cook, M.D.
I was with you also at that lecture that the guy from Hopkins gave up in Marin.
Nafysa Parpia, N.D.
Oh, yeah, long time though.
Matthew Cook, M.D.
And he was saying, oh, you need to be in four antibiotics, but I will say, oh, we do give four antibiotics because we give ozone, we’ll do herbs and often more than one and then LL 37 and potentially thymus and type of peptides.
Nafysa Parpia, N.D.
High dose vitamin C.
Matthew Cook, M.D.
High dose vitamin C, yep, great.
Nafysa Parpia, N.D.
Argentium silver.
Matthew Cook, M.D.
Argentium silver, which is gonna be great both in terms of breaking down bio-forms and stuff like that in the nose, but also intravenously. Yep, and they’re probably the best company from that perspective. And so then, we’re up to six or seven, in terms of, and then that kind of gives you the idea. And I like, then imagine that if you were going along in your life and you were a patient of Nafysa, all of a sudden something happens that was crazy stressful. And so then immune stress comes like right here, but then you might come in and give one or two or three of those things, but probably not all of ’em, and then bring them right back down to here.
Nafysa Parpia, N.D.
Exactly that. And you can come in with peptides quick, boom.
Matthew Cook, M.D.
Peptides quick too. And so then we’ll often talk to people who actually have an evasion, we’ll give ’em LL 37 right away. And they could come in for an IV vitamin C and then we’ll bring that down. And so then part of taking care of complex illness is I think, really clinically figuring out everything that’s happening, making a map of that and then making a plan to kind of treat that and then do all the things that we do. But then the other part of that is then having an overall strategy of what constellations were using to treat cannabis, we go, but then having strategies to basically when the wheels start to fall a little bit off the bus. ‘Cause if you use that, we fix it before it comes all the way off.
Nafysa Parpia, N.D.
Yeah, so we’re watching our patients like with eagle eyes. I mean, eye watching, because I know everybody is gonna surprise me in some way, everybody, somebody, every day is gonna react in a way that’s opposite.
Matthew Cook, M.D.
Humbling, yeah. That aspect of medicine is so humbling, I can’t believe it.
Nafysa Parpia, N.D.
Yes, so we have to watch them, and then they’re removing target. Every time you give ’em therapy, something’s gonna change usually for the better. Sometimes it was too much, it goes the other way, it was the right medicine at the wrong time or too high dosage, we have to dial it down. But when you give someone something and it goes the wrong way, it exposes what’s under the surface, it exposes where the problem is, very often. So like I tell ’em, well, it’s good in a way this happened, not that I want you to suffer with that. Thank God it’s just a day, maybe three days max of feeling bad, but it shows us where the weak link is.
Matthew Cook, M.D.
I love that, yeah, that’s a good one.
Nafysa Parpia, N.D.
Yeah.
Matthew Cook, M.D.
But back to peptides for neuro-inflammation, C-max, C-lank and cerebral lycin, potentially.
Nafysa Parpia, N.D.
Lycin, yeah.
Matthew Cook, M.D.
How’s your experience been with that?
Nafysa Parpia, N.D.
With cerebral lycin? I like it, it helps them. This one I’ve noticed it gives them a little bit of change if I try to give it to them in the beginning. Whereas the C-max was nothing in the beginning. And then afterwards, when I say afterwards, I mean, the killing is done. Most of the toxins are out and they’re stuck with these inflammatory patterns, these help to break them, I notice.
Matthew Cook, M.D.
There’s a Willie Nelson song.
Nafysa Parpia, N.D.
I love it when you sing at your clinic.
Matthew Cook, M.D.
There’s a Willie Nelson song, “The Time of the Preacher.” And he has the line, “The lessons are over and the killings begun.”
Nafysa Parpia, N.D.
It’s perfect, actually right.
Matthew Cook, M.D.
I think yesterday it was Willie Nelson’s birthday.
Nafysa Parpia, N.D.
oh yeah.
Matthew Cook, M.D.
We were singing quite a bit of songs. It’s interesting, my ability to sing got about 100% better ever since I started doing peptides.
Nafysa Parpia, N.D.
Really?
Matthew Cook, M.D.
And I think it just neural, I don’t know whether, and my memory and everything went way up. And so then I just kind of, I wonder, it’s definitely fixing neurological inflammation. And if now what happens is then I’ll do typically an IV, and then after about 2/3 of the way through the IV, all of a sudden I’ll feel like a vibration in my chest. Like I can feel it now. Like I would be able to sing well, and it probably our favorite thing. And I’ll talk to people who also will start to feel this, the more they start to do it. And like, when we, all the people who we really liked, like I couldn’t sing at their register, like I could never sing Elton John, I could never sing with Jackson Brown. And then now basically 100% of the time, if you were with us, we would be like singing along–
Nafysa Parpia, N.D.
So next time they come and visit you, come visit us, you’re gonna have to sing.
Matthew Cook, M.D.
Okay, that sounds good.
Nafysa Parpia, N.D.
I wanna hear it.
Matthew Cook, M.D.
Well, that was an amazing conversation. Anything else on peptide or a complex illness or a detox or wellness front you wanna tell me about?
Nafysa Parpia, N.D.
I just wanna tell the patients that there’s hope, they come to us and they’re a little hopeless. They don’t have a diagnosis, or they have waist basket diagnoses, like fibromyalgia, chronic fatigue syndrome, and they don’t know what it’s being caused, when you come to doctors like Matt and I, we investigate to find out what is really underneath there. And we treat that and we treat your symptoms at the same time and we get you better.
Matthew Cook, M.D.
And so if I wanna come see you, how do I find you?
Nafysa Parpia, N.D.
I’m at Gordon Medical, the website is www.gordonmedical.com.
Matthew Cook, M.D.
Okay, fantastic. Well, it’s a delight for me to talk to you, I give you my very highest recommendation. If you have complex on this, or if you’re interested in this stuff, go find them and go see ’em and talk to ’em, ’cause they’re amazing human beings and amazing doctors. And I’m grateful to have you as a friend.
Nafysa Parpia, N.D.
Thank you, Matt. I’m grateful to have you as a friend and I highly recommend you. I want, I mean, I’ve gotta tell our audience about your injection therapies. It is your podcast, but like I’m gonna tell them that you can heal pain very quickly and masterfully, I’ve never seen anybody with a needle like you, so. Tell people what you do.
Matthew Cook, M.D.
Oh, thank you. The really interesting since this is a Peptide Summit, the interesting thing about that front and I have a good one for you, that’s a good one. And I was teaching this at this peptide certification last over the weekend. But imagine that what I do is I do nerve hydro-intersection basically at every nerve in the body, where I would use an ultrasound and I would put my needle right next to a nerve and then create a halo of fluid around it.
Nafysa Parpia, N.D.
I’ve watched it guys, it’s…
Matthew Cook, M.D.
It’s kind of amazing.
Nafysa Parpia, N.D.
To watch, amazing.
Matthew Cook, M.D.
But now I’m doing, I’m teaching people a lot of times to go right near where a nervous is and then grab a little subcutaneous tissue and then put peptides superficial to that nerve.
Nafysa Parpia, N.D.
I love it.
Matthew Cook, M.D.
And so then, but it’s an approach to do. And I find that it’s very helpful and very helpful along the lines of, when we use peptides, and so like when I do peptides for Barb at home, I never inject in subcutaneous tissue. I just say, oh, okay, where does that? What hurts today? And then whether it’s in the leg, and so I have kind of a little, when you come, I’m gonna show you my kind of updated, how I’m doing it, but then I’m doing little subcutaneous injections anywhere where people have pain.
Nafysa Parpia, N.D.
Me too, I do that.
Matthew Cook, M.D.
Yeah, so then, but imagine if you could hear, I think that might prevent 30% of what I do, and I’m always kind of looking to push things more out into consciousness and society. And then as a, if you can really begin to impact pain in that way, it’s such an amazing, and then interestingly, we’ll find the same thing where injecting with an insulin needle by joints, then can be very helpful in terms of managing pain, both where muscles kind of insert around joints. We kind of buy the meniscus and kind of all over. And obviously we know the anatomy pretty well, so we’re comfortable doing that. But then what we do is we’re starting a journey of teaching people where they can do things safely. And then it’s kinda like everything else we’re talking about. And a lot of patients with complex illness will have pain. People with injecting tiny little insulin syringes around areas that hurt and beginning to kind of modulate that I think is–
Nafysa Parpia, N.D.
It changes. I mean, I’ve had people just after I’ve given them just subcutaneous injections of BCP-157, have tears in their eyes. Like, I thought I had to live with that pain forever. And this went away instantaneously, just simple shots like that, it’s magic.
Matthew Cook, M.D.
That’s why I have a little bit of a missionary appeal towards kind of having these conversation because we really grew up in the opioid epidemic. I mean, the San Francisco, when I was a resident at San Francisco General Hospital and at Penasse’s and the VA at UCSF was this opioid epidemic. And then we were at the same time in the world of anesthesia, they called pain the fifth vital sign. They gave us a big lecture on my second year, and they said, we need to stamp out pain. And then they said, and here’s how you do it. You’re gonna do it with these opioids. And so then they’re gonna be really strong and we’re getting better and better opioids. And so then they like weaponized a whole generation of anesthesiologists and pain doctors to go give, but then you get this, we’ve created an entire generation of people that are dependent on opioids. And interestingly, things like BPC-157 tend to regulate. And just like the immune system can get regulated, peptides can regulate peripheral nerves. And then when you regulate and calm those nerves down, a lot of times they have less pain.
Nafysa Parpia, N.D.
Right, TB4-FRAG has that neurological, I read, I haven’t looked at the research on it, but maybe you can tell me a little more about that if you know about nerve regeneration.
Matthew Cook, M.D.
So then, there’s a patent for thymus and beta-4 and peripheral neuropathy. That’s gonna be one thing. Number two, there’s an immune benefit to thymus and beta-4 fragments, and many patients with nerve pain have an immune component to their pain. So you’ve got that aspect of it, the fragments of thymus and beta-4 are extremely anti-inflammatory and almost all neuropathy. Apathy means it’s inflammation. And so then there’s an aspect of just regulating the inflammation. The next thing is that the 17 to 23 fragment is very helpful in terms of promoting connective tissue and healing connective tissue. And then if you said, what would be like, kind of at a high level, somebody told me, and I loved it, that they said this, they said, they watched while watching me. And they said, “Oh, you know what? “I think you do is you just go to different places “in the body and find where nerves are inflamed “and then fix the connective issue there “and make that issue less inflamed, “and then the nerve heals.” Which I was kinda like, oh yeah, that is exactly what I do.
Nafysa Parpia, N.D.
That’s what I see you do.
Matthew Cook, M.D.
So then interestingly, placental matrix is anti-inflammatory and the science that it will help axonal growth. The peptides at some level are gonna be doing that from anti-inflammatory and connective tissue, there’s gonna be some neurological mechanisms. They’re also gonna, there’s also for BPC-157, we’ll promote angiogenesis, and so it’s gonna promote blood vessel health. And 100% of nerves have blood vessels somewhere nearby because they need support. And so then, so there’s gonna be a diversity of, and then for example, thymus metaphor fragment one to four is even more anti-inflammatory than 17 to 23. And so then, you’ve got a, and then you’re gonna probably have some peptides that are gonna actually have direct neurological mechanisms. And so, and then you’re also be able to impact nerves by just making the mitochondria and that nerve healthier, and then it’s gonna work better. You could do that with mitochondrial peptide or you could do that with supplements and all of that whole or with NED.
Nafysa Parpia, N.D.
NED I was about to say.
Matthew Cook, M.D.
Yeah, so but then this would be 100% like everything that I do, and like, everything that you do, there’s not one answer, there’s a diversity of answers. There’s a diversity of things that we have, and there’s simple things and more complex things. But then I think if you’ve got pain, if you’ve got complex illness, if you’ve got both, now you’re beginning to hear, oh, there’s probably some things that I can do at home. There’s some things that I can kind of begin to do with certain people. And so then now, you kind of get into this evolving process. And then that takes me back to the number one thing that I’m trying to do is give a little bit of hope, like you said, oh, there’s hope. And we’ve got you, it’s just a journey.
Nafysa Parpia, N.D.
Exactly that, it’s a journey. People come out even more involved than when they started in their spirit, in their mind and their, in their hearts. I mean, it’s so beautiful to see people at the end of the journey, they’re done and then going in the world, they have their lives back and they’re wiser in their own way.
Matthew Cook, M.D.
Yeah, that’s, well, if you can shepherd people through that, I almost, as I’m listening to it, I feel like I kind of went through that myself in a way, because, I gave this lecture, and somebody asking a question and I don’t know what kind of caused me to go down, but then like eight people came up to me afterwards, and thanked me for saying it. But I said, at some level, everybody here in this room is a doctor or a practitioner, but fundamentally you realized you kind of had a problem, and so you got into integrative wellness because you’re trying to solve your own problems. And that was kind of, I think at some level, the case of me, partly, just because I was breathing in halogenated hydrocarbons all day during anesthesia, ’cause the gases, you can’t keep from breathing some of that stuff in and toxins and stuff like that. And then the detox strategies that you talk about, it’s amazing. When I first did those, it was very difficult. And now I just feel crystal clear all the time, and then when I do those IVs, I feel even more perfect, but I can’t imagine being alive without knowing this is like the greatest thing that I ever discovered in my whole life.
Nafysa Parpia, N.D.
I feel the same way, Matt.
Matthew Cook, M.D.
Is it amazing?
Nafysa Parpia, N.D.
We’re so blessed. To know these things and to work with the patients that we do, so.
Matthew Cook, M.D.
Oh, no, it’s my favorite thing in the world, but actually I’m 50, 50, it’s 50% working with the patients that I do and 50% talking to the doctors like you, because we’re kinda sharing information. And so, what’s gonna happen is in our personal lives, you and Eric come have dinner with us. And in the meantime, what we’ll do is think about a topic and then I’m gonna have you come on our just regular podcast. So look out for that, everybody. And thanks for listening, and we we’ll talk to you soon.
Nafysa Parpia, N.D.
Thank you so much for having me, Matt. So great as always.
Matthew Cook, M.D.
Oh, you’re welcome, you’re the best.
Nafysa Parpia, N.D.
Thank you.
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