A 2024 study out of Tulane University elucidated a mechanism in which lyme and post lyme / long lyme patients can experience chronic neuroinflammatory symptoms. . The research focuses on fibroblast growth factor receptors (FGFRs), a family of proteins involved in various cellular processes. Dysregulation of FGFRs is implicated in a variety of diseases, and now this study suggests that Lyme disease may be among them.

Histamine intolerance is sometimes confused with mast cell activation syndrome, though they are related conditions. Patients with either of these conditions may have trouble metabolizing histamine, and serum DAO testing is one way of assessing the patient’s ability to breakdown histamine. Lowered levels do correlate with some conditions and with symptoms, and can be useful from a testing perspective.

A good proportion of my practice has been directed to helping patients who are sensitive to mold and mycotoxin related illness. While often we can get confirmation of an increased body burden of mycotoxins (toxins, or secondary metabolites from mold) through [urine testing](https://pannaturopathic.com/mycotoxin-testing), there are some warning signs or hints in the history and exam that often lead us discuss such testing.

A presentation between Moleculara Labs (who runs the Cunningham autoimmune encephelopathy panel) and Dr Kenderlehrer was recently posted and has excellent summary points. I have written this post combining some of the information from that lecture as well as my own experiences. Not all mental health issues come from past or current infection associated neuroinflammation, but some do, and considering this possibility may help to find more effective patient-centered treatment options.

Chelation therapy has long been used as part of a detoxification protocol in naturopathic medicine. It can be useful in some patients to lower to total body burden of toxins, but it can be very useful for improving circulation and reducing vascular events especially in diabetics.

Herbal medicine for chronic infections: How herbs can help with lyme and bartonella treatment by modulating the immune system, reducing inflammation, and protecting the nervous system.

• Natural polypharmacy: How combining multiple herbs can create synergistic effects that are greater than the sum of their individual actions.

Leaky gut is a condition that occurs when the lining of the intestines becomes more porous than it should be, allowing toxins, undigested food particles, and possibly bacteria to leak into the bloodstream. This can trigger an immune response, leading to chronic inflammation and potentially exacerbating autoimmune diseases. Naturopathic treatments focus on improving gut health, reducing inflammation, restoring the healthy microbiome, and rebalancing the immune system. This may involve dietary and lifestyle changes, incorporating nutrient-dense foods and supplements, and utilizing botanical medicines. Additionally, stress management and optimizing sleep patterns are important aspects of naturopathic treatment. By addressing leaky gut and supporting the immune system, we can take proactive steps in managing autoimmune diseases.

In this 2023 update on treatment options for Multiple Chemical Sensitivity (MCS), we can emphasize the challenges faced by MCS patients in modern urban environments due to their hypersensitivity to chemical triggers.

The approach to managing MCS is discussed, focusing on identifying unique triggers, addressing neurologic hypersensitivity, managing psychiatric co-morbidities, and promoting immune system balance and detoxification.

We utilize the concept of "total body burden", highlighting the importance of identifying and reducing burdens like mycotoxins, heavy metals, and infections.

Various treatments including acupuncture, nutritional approaches, and ozone therapy are considered, emphasizing their potential in modulating the immune system and reducing symptoms.

Understand how environmental toxins can accumulate within the body and how targeted detoxification methods can be a powerful ally. Discover the array of naturopathic detoxification methods and their potential to support the body's inherent detoxification mechanisms.

effective approaches to manage Herxheimer reactions in chronic infections. Learn about the relationship between chronic Lyme disease and Herxheimer reactions, the importance of addressing and managing them, and explore strategies for pre-treatment, during-treatment, and post-treatment care. Minimize symptoms and optimize long-term outcomes

Treatment for bartonella has a wide range of different options, with varying associated risks. In all but more acute cases, my experience has been that while different therapy options have different risk profiles, the likelihood of benefit is not necessarily correlated with the risk.

In other words, more risky interventions such as drug antibiotics do not necessarily have more likelihood of benefit than less risky interventions such as herbal antibiotics, [immune system supportive treatments](https://www.pannaturopathic.com/new-page-2). At least this applies in chronic cases: in a situation of new infection, or if there is evidence of more aggressive infection, such as overtly abnormal inflammatory markers, possible tissue damage from inflammation (eg [an endocarditis](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5475225/)) then there is a clear benefit to the more potent drug antibiotics.

Discover the connection between thiamine and brain fog, including how SIBO can lead to thiamine deficiency and vice versa. My experience with micronutrient therapy in brain fog and SIBO as well as related conditions.

On one of my recent morning runs, I was enjoying a podcast episode that described one persons journey in treating his SIBO and malnutrition. The actual title of the video involved recovery from SIBO and fibromyalgia, but the reason I clicked on the video was the thumbnail that showed a quite striking change between a very low body weight, young adult, to someone who seemed to put on much more lean mass in a healthy way.

Central sensitivity syndrome (CSS) is a condition that affects the way the brain processes sensory information. People with CSS experience increased sensitivity and reactivity to stimuli that would not bother most people. This can result in pain, fatigue, anxiety, migraines, insomnia, brain fog, and other symptoms.

Creatine is a well-known supplement that is used in the bodybuilding world. It is normally used to improve short-term energy generation when lifting weights. Dietary sources include red meat, seafood, and poultry. The amino acid sources are arginine, glycine, and methionine. Dietary shortfalls can be made up by production in the kidney and liver.

Many supplement it before workouts. **But creatine is likely also useful in brain fog and other cognitive symptoms.**

Many patients ask about "die off reactions" and attribute a variety of symptoms to this process. **Candida die-off is technically called a herxheimer reaction, and is related to inflammatory symptoms that arise from candida metabolic products beign released by break down of the candida cell wall.** In practice, it is relatively rare that I see candida die off as being the main reason a patient is experiencing symptoms, unless they are on a new medication regime for candida.

As spring nears and there already has been some better weather, we will do well focusing on spending more time outside as a means to improve our health. For many years, I thought some of the most studied benefits of being outside related to simply vitamin D production from the sun, as well as improving mood in cases of those who may suffer from seasonal affective disorder.

However, since COVID, there has been quite a bit a renewed interest in other mechanisms of how light therapy, including being outside, can improve markers such as inflammation as well as energy production within the mitochondria.

Light therapy, in particular infrared energy, affects our circadian rhythm and helps our mitochondria to function optimally. Mitochondria are the powerhouses of the cell; they are the engine that drives energy production. Sometimes engines are prone to "overheating" and can suffer from oxidative stress. This ultimately impairs their ability to generate normal amounts of energy efficiently.

LivLyme once again had a wonderful, information filled conference this year in 2023, with many physicians and specialists sharing new information as well as reviewing old experience and data; both of which are relevant to patients and practitioners working with chronic conditions.

The notes below are by no means a comprehensive log of the information presented, but rather what I felt were either new interesting pieces of information or excellent summaries of experience in treating these conditions in patients.