Episode 40 : Marna Regehr, FNP on Addressing Acute & Chronic Lyme Disease
Show Summary:
Whether it is a loved one or yourself, we all have been affected by Lyme Disease in one way or another. Lyme Disease can be a devastating and mysterious disease that is also becoming more common.
Today’s guest, Marna Regehr, is a nurse practitioner at CIH with a passion for disease prevention using traditional and complementary modalities. Marna specializes in treating Lyme and is here today to discuss what Lyme Disease is and what approaches we can take to treat it.
Join us to learn more about Lyme Disease and what you can do to support yourself or a loved one along the path of treating it.
Timestamps:
0:00 - Introduction
2:32 - How Marna got into integrative medicine
5:48 - How Marna started with CIH
7:31 - What is Lyme Disease?
10:08 - Lyme Disease is underdiagnosed
11:30 - When are ticks most prevalent?
12:0 - How to be prepared in the outdoors
14:14 - Antibiotics and acute Lyme
17:08 - The bullseye rash isn’t always there
18:57 - Symptoms of acute Lyme Disease
21:45 - Symptoms of chronic Lyme Disease
25:38 - Different types of Lyme Disease
31:13 - Different types of testing
32:12 - How chronic Lyme can be treated
39:31 - How does stress and lifestyle impact Lyme Disease
44:18 - Marna’s morning routine
45:20 - What Marna does to cultivate joy
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Full Episode Transcript:
SPEAKERS: Dr. Andrew Wong, Marna Regehr
“I will tell you at this point in my life I definitely believe in chronic Lyme. There's something going on. I have had patients that you know that have been diagnosed with Rheumatoid Arthritis are with chronic fatigue, fibromyalgia you know, and some joint pain but just brain fog. They just don't feel right you know and you know doing a history is really important. I said, well when did this all start? and sometimes it is very interesting how there was I was just fine up to this point all right well what were you doing at this point doing a really comprehensive history, did you do you hike? do you have a dog? where were you living? and you know was there a point where this really started and often when you do a really good history you find it was after this time and well yeah you know I was hiking at that time some of them say oh you know maybe I got a tick bite but I didn't notice anything so I didn't do anything you know” - Marna Regehr
Whether it is a loved one or yourself we have all been affected by Lyme disease in one way or another. Lyme disease can be a devastating and mysterious disease that is also becoming more and more common and it is also underdiagnosed. Today's guest Marna Regehr is a nurse practitioner right here at Capital Integrative Health. She has a passion for disease prevention using traditional and complementary modalities. Marna also specializes in treating Lyme disease and is here today to discuss what Lyme disease is and what approaches we can take to treat it.
I am Dr. Andrew Wong, co-founder of Capital Integrative Health. This is a podcast dedicated to transforming the consciousness around what it means to be healthy and understanding the root causes of both disease and wellness. Join us to learn more about Lyme disease and what you can do to support yourself or a loved one along the path of treating it and healing from it.
Dr. Wong
Well, Marna welcome to the podcast so great for you to be here.
Marna
Thank you, good to be here.
Dr. Wong
And Marna is one of our OG’s at Capital Integrative Health and here since the beginning so we're so happy to finally have you on the podcast to talk about Lyme today. We know that Lyme disease is a really big topic, a really big concern for a lot of people you know out there a lot of listeners maybe they might have family members or themselves even loved ones that have lime. But let's first start about you and talk about you know how you, Marna, got into integrative and functional medicine.
Marna
Okay yes. I think you know my sister was involved in sort of Natural Health many many years ago and she had her own little herb shop and so I just had a lot of interest in it and a lot of influence from her and then as a nurse practitioner for a while and or as a nurse just working as a nurse for a while and I thought how can I really maybe help people you know more with natural health and I thought going back to nurse practitioner school maybe I could be a little bit more directive and so that's what I did and then my first job I worked with a doctor that really taught me a lot in my very first practice and he did a lot of I had a lot of patients that had a Lyme so I thought Integrative Medicine. I didn't know that it had so much to do just with chronic disease in line but that's where I learned a lot about treating lyme.
Dr. Wong
So you're already leaning towards more holistic medicine. You kind of stumbled into that practice and started learning about Lyme through your experiences with the patients there.
Marna
Exactly, exactly, you know.
Dr. Wong
In Leesburg. How did you find those patients did with that kind of treatment with more in-depth treatment of Lyme?
Marna
You know Lyme treatment is always a challenge you know and some people you know did definitely better you know but it's always an ongoing treatment you know for a while but yes. But in my treatment even here as I have looked back patients that I've treated with Lyme I go you know they do get better you know and I mean sometimes it's not, it's a process which we'll talk about today but you can get better as you treat the whole person you know.
Dr. Wong
Yeah looking at all the systems connect. Mind-Body-Spirit.
Marna
Yeah. I know my first patient that I almost treated her Lyme I thought great I'm going to put her on doxycycline for two weeks and she's going to be healed and the doctor that I was sort of working with to sort of remained very quiet.
Dr. Wong
Like that's the traditional approach.
Marna
Yeah right. Because, no because I mean the integrative doctor I was working with because he knew is probably going to be a little longer process than two weeks.
Dr. Wong
There's more chapters in that book than the first chapter, right? And you grew up in Kansas. So is your, was your sister's herb shop in Kansas. Basically was there any Lyme in Kansas?
Marna
You know not really I never was aware of too much of Lyme until I got more into Integrative Medicine you know. I mean no in nursing, of course, I dealt with it as stuff as well you know people that as a nurse you know definitely heard more about it.
Dr. Wong
Heard about it, yeah.
Marna
But I think it's not as endemic in Kansas believe it or not partly because I think you know it's more wide open spaces you know and so there's an and there's not as many trees and not as many deer you know. I mean it's definitely there but it's more endemic on especially on the east coast and on the coast.
Dr. Wong
Yeah the wooded areas, yeah. It's kind of hide in there.
Marna
Exactly.
Dr. Wong
Deer are you know.
Marna
Right.
Dr. Wong
Bambi or whoever's going in there hopefully Bambi's not getting infected by a tick but.
Marna
Right.
Dr. Wong
And let's talk about how you started working at CIH, that was back in 2015.
Marna
Yeah right, you know. So I, my first job like I said was in Virginia and I live in Maryland you know and so I met Dr. Wong at a conference that we had together
Dr. Wong
Is it networking, networking dinner? Yeah.
Marna
Networking dinner and then there was actually another doctor that was there as well. Anyway so, I think just I just decided you know that this sounded like a good fit you know, and didn't have to go keep up two different licenses and different things or so anyway so that's when I decided just to sort of exciting you're starting a whole new, yeah like I was here at the beginning started a whole new clinic you know so anyway so.
Dr. Wong
It's been a very fun journey.
Marna
Yeah right here. Right, exactly. So it was great just to be able to have this transition and at that time too. I was also still working just down the street at, as a school nurse you know and stuff so when I started here more I was working part-time and I worked part-time at that job and then and then after a year I thought no I'm just gonna just work here so that was convenient as well.
Dr. Wong
Did you see anyone any kids with tick bites there?
Marna
Oh yes. Oh yeah, definitely saw kids with ticks there and was by that point much more aware and so try to really direct them in the right direction you know if they did get a tick bite, and watch them so.
Dr. Wong
Well, let's get into Lyme.
Marna
Okay.
Dr. Wong
Talk about Lyme disease. What is Lyme disease and what causes it and how is it transmitted, for listeners?
Marna
Yeah. So basically Lyme is just a bacterium that you can, that people can get from ticks. There are probably other vectors out there that you can also transmit them now but we'll stick to ticks so we don't get frighten everybody I mean but sometimes they think you know now there might be other vectors that also can transmit to humans like maybe even some of the mosquitoes or some other maybe small mammals and stuff as well or but basically ticks are very resilient you know this tick a fully engorged tick you know that a female you know that she can lay like a hundred to ten thousand eggs at one time. A little larvae and these little larvae then fall to the ground you know and then they sort of shelter and hide in the grass and then they find these smaller little vectors like, you know, like white like a whitetail mouse is known to really be a nice vector for them in the early larval stage and so then they feed on you know they have to have always, they have to have some blood source to live but they can live unfortunately 200 maybe two adult an adult can live almost like 430 days without a blood source. So I mean even if they're not feeding they can still live so anyway. These little larvae then just feed you know they have a blood source on like on a small mammal like a white tail mouse or something and then what they do is they a molt into like a nymph and these nymphs are still really very very very tiny but these nymphs than they look for larger sources you know like a deer or a human and so basically when with these vectors they how you get not every tick has Lyme. So when they're feeding off some of these blood sources that have like a viral or bacterial infection or blood-borne pathogen like a lime then those ticks pick it up and then when they bite somebody else then they can affect infect that person now the vectors themselves usually don't have Lyme you know but if they do have some blood-borne pathogen like the infection like the lime in their system then the ticks, unfortunately, can pass it on to other people.
Dr. Wong
So and how common is Lyme you know, we know that the CDC has certain data but my understanding is, there's some underdiagnosis going on.
Marna
Yes definitely. There's a lot of undiagnosed cases going on and I think partly just even from an environmental standpoint you know, as you know we deforest, deforestation you know basically when we're building into trees and everything else and so the animals are being coming more concentrated like deer and all this and animals you know a lot of mammals are being displaced you know just, especially in coastal areas or where there's heavily treated areas you know lime is just becoming more prevalent and it is very underreported and I will probably get into this too you know the difference between just getting bitten by a tick and getting Lyme and then chronic Lyme and chronic Lyme is probably one of the things that we'll probably talk about here in a few more months you know that really Lyme can develop into a chronic issue and that definitely is underreported and undiagnosed.
Dr. Wong
Yeah. So you said about habitat destruction, deforestation, crowding of you know yeah the population and then there's probably more you know human-animal interactions based on that.
Marna
Exactly.
Dr. Wong
Would climate change be also playing a role?
Marna
Well, I think yes. I think it could you know because that all ties together.
Dr. Wong
Like ticks probably like warm weather. Is that true or do they like cold weather also?
Marna
Well, they're most prevalent where in spring and maybe early fall I think but spring for sure is where you know with their life cycle that but spring is often you know and that's when people maybe go out more to the woods and stuff too but spring is where you see more often more tick bites.
Dr. Wong
Got it.
Marna
And some areas I mean you can just be infested you know with it and yeah like when I was working at the school and they take hikes and they come back with tick bites, they go ugh.
Dr. Wong
You know yeah that's the problem with earthing you know like going out and barefoot yeah on the grass like yeah it's really good for the body but then it's like is there gonna be a tick there or not?
Marna
One thing I tell patients now sometimes you know if you're going to go on a hike I mean obviously there are some sprays that you can use there's you know some heavy socks that you can put on but maybe just having even a little tea tree oil in your pocket you know because sometimes if you get a tick bite if you notice it right away and you rub it with tea tree oil. I mean it's not I'm 100 surefire thing, but it can possibly you know stop the transmission.
Dr. Wong
Neutralize it.
Marna
Yeah. Neutralize the transmission so tea tree oil could be really good or sometimes even people say like alcohol you know they have a little bit of alcohol you know and stuff I mean obviously you have to pull the tick off and that's a whole nother subject you know but if you just feel like you got a tick that's not really latched on at that point and just rub it with some alcohol or some tea tree oil and it's a whole you know people used to say okay the ticks need to be on there for like 48, 24 to 48 hours before they can transmit lime and that's just not true you know you can it can be less than that and stuff so that is sort of another myth that needs to be busted about learning and Lyme transmission.
Dr. Wong
Yeah. So just going back to the question about the tea tree oil is that a spray you can put on or something you can use for prevention?
Marna
Yeah, prevention there you tea tree oil usually comes as a liquid you know and so just you know obviously if you have any cotton ball or anything your handkerchief or whatever you know just put some of the tea tree oil on it rub it over that spot.
Dr. Wong
Yeah. On any skin that's exposed like if people wearing shorts or T-shirts.
Marna
Maybe as a prevention. I don't know if you could just put it all over, there's some other sprays, there is a, there's some natural sprays that you can use. I have to remember the name of that you know but there are some natural sprays that you can use then there's also permethrin sprays you know that you can use as a prevention.
Dr. Wong
That ticks would be less likely to jump.
Marna
Exactly, yeah.
Dr. Wong
Chemicals and stuff yeah, got it. Okay and then like you said this 24 to 48 hours of having to take on the skin before getting infected is a myth.
Marna
Yeah.
Dr. Wong
Talk more about that and kind of, get into acute Lyme first, yeah.
Marna
The good thing is I mean, so I mean what you have to say a lot of patients do say well I just was on for a short amount of time well and we have seen cases you know with Lyme I mean, especially a lot of doctors that treat Lyme that the tick does not need to be on there for you know even this less than 24 hours you know It still can transmit and so it is really important to get early treatment. So if you get a tick bite you know, you do need to let your practitioner know. I mean obviously, you need to remove the tick. I mean there are different ways to remove the tick I mean obviously you can take a tweezer and be sure you grab it by the head you know not the tail you know or anything like that so you can really pull it out a lot of people are really concerned because you know even after they pull it out and they truly have gotten it out there's just a little hard spot and a little red dot right there and that's because they inject almost what they when they're feeding they inject almost this like cement like liquid that you know that you will have a really tiny little spot that feels hard and that's normal okay you know because that's just because what they inject it becomes really hard doesn't necessarily mean that it increases your chance of getting it but that will be there. So several things to do here is save the tick you know. Because you can get it tested for Lyme and so there's Clongen Labs is one and there's other labs but it's locally engaged but that's locally in Gaithersburg. Clongen Labs is locally in Gaithersburg that you can send the tick for testing I mean like if you just test for just the regular Borrelia burgdorferi I think that's just one price or maybe even that one's free you know but there's and then if you want to test for a lot of different types of Lymes and it gets a little bit more expensive you know but it is really a good thing to just send them in because it is like the lone star tick that usually doesn't you know spread Lyme you know it's the black leg ticks that really spread Lyme so even having just another expert look at it can really be helpful you know and can help determine treatment as well.
Dr. Wong
And there's also a difference between the traditional Lyme tick which is the Borrelia burgdorferi and the, I think the brown, the lone star tick is brown I believe, correct?
Marna
It could be, I'm not like, yeah.
Dr. Wong
It could be, okay, yeah. But this idea that I know the lone star tick can actually cause this alpha-gal allergy to red meat.
Marna
Oh, really?
Dr. Wong
You know there's this issue with sometimes people get bitten by the lone star tick and they get a red meat allergy so that would be an interesting
Marna
Yeah. That would be an interesting, to follow up yeah.
Dr. Wong
Yeah, if people can go to Clongen that's a good.
Marna
Yeah, yeah. Just to get it that's a very good point.
Dr. Wong
Well, that's probably not free. They probably won't offer for you, yeah.
Marna
That's a good thing to remember, so yeah, thank you for sharing that.
Dr. Wong
Yeah, yeah.
Marna
And so I think some, another thing that I just want to mention here too is that a lot of people think “oh you have to have this Bullseye rash” you know and most people maybe only 50 of the people get like a bullseye rash or even less than that. So even if you don't get a bullseye rash doesn't mean that you have not been infected with Lyme and just remember that Bullseye rash doesn't have to be over the site of where you got the bite it can be at different places you know.
Dr. Wong
Huh! Interesting.
Marna
It doesn't necessarily have to be right at the site where you got the bite so it is something to look for but it's not necessarily definitive.
Dr. Wong
I think that Marna really hit the nail on the bullseye so to speak that buzz light rash we know about you know Integrative Medicine often deals with shades of gray.
Marna
Yes, yeah.
Dr. Wong
You know, like and traditional medicine was like black and white, “did you get a tick bite or not? okay, if you didn't if you don't remember it you don't have Lyme” that's not necessarily true because a people's memory that could be questionable.
Marna
Right.
Dr. Wong
It could be that the tick was on there and then it fell off but then the bite happened before.
Marna
Right.
Dr. Wong
You know, so there's many things that can happen.
Marna
Exactly and one of the really in reference to that one of the most important things with that is the nymphs are one of the most infective you know.
Dr. Wong
Okay.
Marna
I mean the adults can infect you as well but nymphs are so so tiny.
Dr. Wong
Hard to see.
Marna
They're so hard to see that you might not even know that you've gotten bit and if you know so that you might have gone to somewhere might have fallen off on its own you know but that they are so tiny they sometimes you don't see them and you don't notice them.
Dr. Wong
What are some other typical symptoms besides a rash? What are their symptoms of acute Lyme if someone's kind of wondering if they should go see their practitioner?
Marna
Right. I tell all my patients if you have a tick might just call me.
Dr. Wong
Yeah, yeah. Okay.
Marna
But still for an acute Lyme for an acute bite like sometimes like kids I've had this is a good example of a kid that goes to camp you know and gets a tick bite and sometimes ticks one of the things that they can just really transmit even apart from the regular borrelia burgdorferi is anaplasma and with anaplasma you know what they do is that you can get a fever you can get pretty high fever and you can probably get some muscle aches and pains and stuff as well but again just to like with anaplasma. Usually, all you have to do is literally treat two weeks with the doxycycline and that will resolve that anaplasma and so that's just one example I think about off the top. But again just in general you know just even with a Lyme you know you can develop knee pain you know and that is one of the really the classic signs you know even with acute you know like joint pain headache you may have a may or may not have a little fever but you just make malaise not feeling good but joint pain and joint pain is definitely obviously in some cases but not a lot you know you can get really swelling you know on the knee and so then you can aspirate that, that can be aspirated at the, to see too if there's any lime there but basically for acute you need just need to watch for joint pain, malaise, just not feeling good, watch for the rash, for the bullseye rash those are can be some acute markers.
Dr. Wong
Yeah. It sounds like joint pain is a possible differentiator like all the other symptoms sound almost like flu-like symptoms.
Marna
Yes right.
Dr. Wong
Although, you don't have to have joint pain right?
Marna
You don't have to necessarily have joint pain especially initially you know especially when we get talking more into the chronic issue.
Dr. Wong
Right.
Marna
You know but those are some of the acute symptoms and really if you catch it in the acute symptoms and you don't have any other underlying you know immune issues then often just treating with Doxycycline for a month I usually still treat for a month there's been some theories that doctors have a purpose “oh just do a two days of Doxycycline, I go no we need to do you know probably minimum two weeks usually a month” just to be sure that it gets covered because we do not want this to get into chronic Lyme.
Dr. Wong
Right, right and let's actually go into that rabbit hole of chronic Lyme now.
Marna
Right.
Dr. Wong
And I go like Alice in Wonderland down that rabbit hole. What are some of the potential chronic symptoms of Lyme? and you know this is also a controversial topic in some ways.
Marna
Yes.
Dr. Wong
In terms of you know some practitioners, some societies don't really believe in Chronicles.
Marna
Right.
Dr. Wong
So let's just talk about chronic Lyme.
Marna
Right. I will tell you at this point in my life I definitely believe in chronic Lyme.
Dr. Wong
There's something going on.
Marna
There's something going on. I have had patients that you know that have been diagnosed with Rheumatoid Arthritis are with chronic fatigue, fibromyalgia you know, and some joint pain but just brain fog. They just don't feel right you know and you know doing a history is really important. I said, well when did this all start? and sometimes it is very interesting how there was I was just fine up to this point all right well what were you doing at this point doing a really comprehensive history, did you do you hike? do you have a dog? where were you living? and you know was there a point where this really started and often when you do a really good history you find it was after this time and well yeah you know I was hiking at that time some of them say oh you know maybe I got a tick bite but I didn't notice anything so I didn't do anything you know or a lot of times they have no idea but then like what we do here in Integrative Health what we do is we do more in-depth testing and sometimes these people then have just lit up with their Western blots have been positive or we do some testing more for comorbidities I meant not comorbidities but other Lyme doesn't only just give you Lyme there's other things that.
Dr. Wong
Co-infections.
Marna
Co-infections, exactly like Bartonella, babesia and I can we can talk about some of the differentials with that as well but you know and some of these patients then are just so relieved just to have a diagnosis you know some of them, I have a patient recently that has been to just special neurologists and in pain management doctors in New York and all these Specialists you know and so wasn't sure either what was going on with her but then just did some lime testing and it has just lit up you know. So there's a lot of people that come in here with just chronic the things that I already mentioned like chronic fatigue, joint pain, fibromyalgia, just not feeling good for years and then when we work them up for lime it really is positive you know POTS is you know a lot of times if you have POTS a lot of people have POT Syndrome and POT Syndrome is really associated with Lyme you know and so they've been treating for POTS but they're still not getting better you know so.
Dr. Wong
What is the root cause? I mean that's what you’re kind of,
Marna
Yeah. What is the root cause? Exactly.
Dr. Wong
Like an archaeologist, they dig in there.
Marna
Exactly right.
Dr. Wong
A lot of these autoimmune diseases, POTS, Hashimoto's.
Marna
Yes.
Dr. Wong
Some of these things can actually be caused by Lyme.
Marna
Yeah yeah yeah absolutely.
Dr. Wong
And I think in traditional medicine you know we don't necessarily do a great job of being archaeologists we're almost like if something on the surface and it's not there then it can't be there anymore.
Marna
Exactly.
Dr. Wong
But we know that Lyme is really a stealth infection.
Marna
Yes.
Dr. Wong
It hides in the cell, right?
Marna
Exactly, it does. Especially I mean like we can, speaking of one of the co-infections like babesia. Babesia can be an intracellular. There's different lots of times that there's a lot of different types of babesia but one type can be an intracellular so then it can cause anemia and can cause like low hemoglobin hematocrit and cause anemia and so that can be one sign too that you have to watch for so again on just digging deeper you know and again the history so important so.
Dr. Wong
Are you a fan of science fiction at all Marna?
Marna
Ah, it's a little some of it.
Dr. Wong
Well, I mentioned that because it's kind of like Lyme is like a shapeshifter like yeah. Can you talk about kind of outline for the audience the different types of Lyme you know there's different types?
Marna
Right, and one of the questions, when people come to me, is I really do ask them some other questions and so you know like general Lyme will be some of the symptoms that we have talked about then I sort of differentiate Bartonella and babesia are two real common co-infections. And so with babesia again what I look at, you obviously you look at your RBC the CBC indices and iron levels you know just be sure there's no anemia and stuff there but one thing too because that some forms of babesia can be an intracellular parasite sometimes what is exhibited with people that have babesia as a shortness of breath they just I ask them do you just have to take a deep sign respiration intermittently and often they'll say yes so that's another sign of babesia you know is just the shortness of breath sometimes they can have like pain sort of on the bottom of their feet I think that can probably be a little bit with Bartonella just even on as well headache you know I'm emotionally labile you know just you know mood issues.
Dr. Wong
With Bartonella?
Marna
It was probably more with maybe more babesia.
Dr. Wong
Babesia. Okay, oh yeah.
Marna
But another big thing with babesia is sweats, do you have just sweats? not just night sweats but you can have sweats and chills and fever with babesia so that is one thing you know the shortness of breath, the sweats, chills and fever and headache you know and of course the anemia and the sign respirations then moving to Bartonella. Bartonella is hard. Bartonella is tough because Bartonella can often do more neurological symptoms you feeling of like bugs crawling on your skin you know neurological pain like you know like in your face you know neurological pain of this sort of pain along a nerve line you know and a lot of paresthesias you know as that also go along with Bartonella and just really migratory joint pains and now there is a Bartonella rash you know a real stray Ray rash so it's sort of like a stretch mark rash and that is for a very, that's a pretty much a clinical sign I mean you can have stretch marks for other reasons but very distinct stretch-mark-like rash that's some kinds can be vertical but actually more horizontal as well and that's another thing that you can look for with Bartonella but it's a lot of the neurological symptoms the paresthesias, nerve pain that is really sometimes really hard to deal with you know and stuff like that's a more of a sign of like sometimes they also describe sort of an internal vibratory feeling and just.
Dr. Wong
Kind of these strange symptoms.
Marna
Yeah.
Dr. Wong
Are hard to explain from traditional diagnosis.
Marna
Yeah, yeah and that can often be more Bartonella. So I asked the patients these questions because I mean obviously, we can do more testing to fair it out whether it's more babesia or Bartonella but these symptoms can also help clarify.
Dr. Wong
So I mean in a way, finding these kinds of infections or co-infections is kind of like finding a needle in a haystack.
Marna
Exactly, yeah. Exactly.
Dr. Wong
How do we test or how do we find you know how do I, how do we identify Lyme?
Marna
Right now here at CIH. We have some specialized testing that we can do so basically there are some, just some lab tests that I do, the Western blot, there's antibody tests that we can just do through LabCorp but then what we do is we do some specialized testing too we've often used and still continue to use IGeneX Labs which is a little bit more they add an extra band sometimes too, I think maybe one or two extra bands that they do for the Western Blots and they can do some R they do some DNA testing as well for like Babesia and Bartonella that we can do so they are very well respected lab that we use here that can give us a more differential diagnosis and then what we've also been using here more lately is vibrant mycotoxin labs and what I really like about them is they do a whole panel of co-infections and having recently gone to ILABS you know. ILABS is the International Lyme and Lyme Associated Disease Conference. A lot of really Lyme experts are using, they use both IGeneX and these vibrant labs you know and so there's just more testing always being developed but this vibrant mycotoxin, the co-infection one can really be helpful in looking because it tests for about I don't know four or five different types of Bartonella, Babesia, Anaplasma and then they do also some RNA testing as well.
Dr. Wong
Okay good. Uh, well, a lot of tests that are out there some of these more functional tests I think it's really important to know that for the listeners that those tests are out there. There's practitioners that can't order them because if someone's struggling with you know months or years of chronic fatigue or fibromyalgia or joint pain, headaches, whatever it is and there could be Lyme co-infections having a negative Labcorp or sort of a more traditional lab test here may not rule out Lyme. How accurate is that?
Marna
Right. Oh, I agree exactly with what you said. Because I've done a Western blot although there might be one band or two you know it's like oh I don't know but when I go through all my questions and the symptoms I think I don't know we need to test you further and I've had people that the Western blot has been even pretty negative and then some of the specialized testing just lights up so it is really important, yeah and worthwhile to do some of the specialized testing.
Dr. Wong
They're more precise.
Marna
Yes, yes exactly.
Dr. Wong
So, we talked about Babesia, Bartonella, Anaplasma, we talked about Lyme a bit. Acute and chronic. Let's kind of get into for listeners things that we might want to consider in terms of treatments.
Marna
Okay.
Dr. Wong
And sort of uh, where do we go from here? We have a diagnosis of I know Lyme now and you know someone's actually getting some light maybe at the end of the tunnel. How do they kind of move through that to uh, to get to the other side?
Marna
And let the fun begin!
Dr. Wong
Yes, yes, exactly.
Marna
It is you know, I approach everybody individually you know. Definitely here, what I use and I think all the practitioners here use we do a combination of antibiotics and herbals, herbal supplements, there's several good companies that like Nutramedix, has a lot of good herbal products. Byron white products, we use a lot of those there's some other companies that I'm investigating a little bit more you know for Herbal products there and so it's usually a combination you know sometimes too I think before we get into Lyme treatments per se I think something that I think CIH does really well is that we look at the whole person as well. Maybe even before we do Lyme treatment, we need to look at their GI status, we need to look at their detox pathways, how are they detoxing you know because if I start somebody or if we start somebody on antibiotics you know but their detox pathways aren't open or they just have their GI system isn't working properly then all the things I throw at them may not be as effective you know and so, and this is really interesting too. I've been going to ILABS the conferences for quite a few years you know and oh and four or five years ago you know it's all about, all right what's this new antibiotic, how we can do that and how you know and breaking how can we give even some things that break up cysts like kinase or cyst busters you know so that even the antibiotics can be more effective. And so one year it was all about that you know cyst busters to help the antibiotics be more effective in the last couple years it's been very interesting where the more the tone has been and even the title of one lecture was it ain't just one thing you know and so I think even the very people that treat Lyme that are really Lyme literate doctors are seeing it's not just treating Lyme it's treating the whole person and I think that's one thing that we do well here and so that's probably where I start is asking you know, what is the GI status? you know, are they having, do they have SIBO? do you know are you constantly constipated? or something like that. So we need or there may be mold or something or heavy metals that we need to maybe detox first so that the treatment with Lyme can be the most effective.
Dr. Wong
It ain't only one thing right.
Marna
It ain't only one thing, is right.
Dr. Wong
I love that shift in perspective, slight shift in perspective of ILADS from I think just more of a bug based versus like yeah we have to treat the bugs but also nourish and strengthen a terrain itself.
Marna
Exactly exactly, yeah yeah. So then getting into actually treating Lyme after we've you know done some of the preliminary work you know it depends a little bit on the person. Some people really don't want to do antibiotics you know. Doxycycline is really effective for acute Lyme but not so effective for chronic Lyme. Sometimes I start there anyway at the very beginning, so I just know I've covered all my bases you know there's other obviously I don't want to talk too much about specific treatment here because everything is very individual.
Dr. Wong
This is not a treatment podcast.
Marna
This is not a treatment podcast but there is one naturopathic doctor that I have read about you know and so she starts somebody that's maybe come in that I suspect has chronic lyme and sat it for a long time. Sometimes you know you start on a drug maybe like Tindamax which actually is an anti-parasitical drug but it also is a cysts buster you know and stuff, so you know you want to get I mean again we think that ticks are very strong and have a strong on the outside but you know they, what they went in chronic Lyme they burrow in your system they hide in your cells you know and they do you know put these little protective walls around them you know and so sometimes we need to like, if we use a drug an antibiotic or an anti parasitical like Tindamax that can push them out and then you might give them Zithromax after that because okay we're going to push them out and then we're going to try and zap them you know. But it's always important. One thing that I always, do you always need to know do at least two therapies at one time. Whether it is you know like an antibiotic along with a an herbal supplement of some kind like I use AL, a lot AL has been known to be advertised as a doxycycline in a bottle you know you know because it treats AL stands for Anti-Lyme it's a Byron white formula but because it just treats the gamut of a lot of different things and so but it's I think it's really important to do a combination of an antibiotic or herbal supplement that targets Lyme in some way.
Dr. Wong
If someone doesn't want antibiotics then you could combine herbs.
Marna
Yeah, you could combine herbs as well, you can definitely you can if people does not want, if people do not want to do any antibiotics then there's definitely some herbal supplements that I can start with as well.
Dr. Wong
There's multiple hiking pathways to get to the final exact destination.
Marna
Exactly, absolutely.
Dr. Wong
Okay.
Marna
Absolutely and some people just really you know it's interesting. I had a patient one time that had before, she came here she had a Lyme so bad that she was wheelchair bound.
Dr. Wong
Wow.
Marna
You know and then what she did something called the Cowden protocol and the Cowden protocol is like a bunch as like a Nutramedix you know and so they, you're on it for about nine months and one day you take a little bit of this mixture of this tincture then the next day you take a this tincture and the next day you take this tincture and so for some people that I have treated with you know antibiotics, different things sometimes, I just you know and if it has to be the right patient it has to be the right situation but sometimes just going on a long-term herbal treatment has been effective you know this patient that was wheelchair bound had done the Cowden protocol and although she still had some Lyme symptoms but it, she's not wheelchair bound anymore.
Dr. Wong
Yes, that's a great story thanks for sharing Marna. And I know, you know, we know here at CIH that you know the treatment of Lyme like any chronic disease also rests on the pillars, the foundations of Health like nutrition, lifestyle, stress management. How does that kind of play role with Lyme patients and what kind of recs you know would you recommend there?
Marna
Yeah. One thing you know I mean I think with when you talk about those pillars you know stress management is so important, nutrition is so important. Ticks and Lyme love sugar. Okay they love sugar and they love alcohol you know. What's in you know so you need to watch your sugar, you need to watch your alcohol because there's a lot of sugar in alcohol. So limiting sugar and alcohol is really important and stress such a big factor so important to deal with underlying causes of emotional issues you know I think some people especially with my original physician that I worked with that taught me a lot about Lyme he said some people don't get better because they haven't dealt with the underlying emotional issues and when you deal with some of the underlying emotional issues uh then you begin to heal.
Dr. Wong
So the immune system in a way is affected by the emotional.
Marna
Absolutely! yeah, yeah.
Dr. Wong
That's, that's a great point, That's a really great point. It's really mind-body-spirit.
Marna
It is really mind-body-spirit because you know if you're, if you're really stressed that stresses your immune system and that pulls it down you know and so it's really important to deal with stress because it does affect your immune.
Dr. Wong
It almost sounds like the immune system is getting bogged down.
Marna
Exactly.
Dr. Wong
By this emotional bandwidth that's getting taken up by immune.
Marna
Right.
Dr. Wong
By emotional balances I mean yeah, and they can't fight the ticks as well and things like that.
Marna
Yeah, very well said very good.
Dr. Wong
How about sleep? Any, any issues there?
Marna
Oh yeah, sleep of course. I mean again I think that's one of the pillars of health. Sleep is very important you know and for all of our health you know very important for our brain health you know and to be able to think clearly and just we all need sleep just to, for restorative sleep you know. So sometimes maybe even doing a sleep study you know but just purposely trying to you know we have whole podcast. I won't go into it I'm sure there's whole podcasts that we do and we have excellent clap classes just on sleep hygiene of things that you can do you know to get enough sunlight to during the day. So you sleep better you know especially early morning you know and basically to go to bed at a regular time but sleep is very important. A little caveat here too with exercise, exercise is really important as well but when somebody is very fatigued to begin with and they might start to get in better people want to go okay I'm just going to really push through with exercise you can't when like when you're doing some Lyme treatment you know I sort of tell them not to over exercise you know you need some exercise for that circulatory system to just wake you up keep you going and it's so good for your mental health but isn't the time to take on maybe a whole new heavy lifting gym routine.
Dr. Wong
Okay, all right, no marathons.
Marna
No marathons.
Dr. Wong
So a medium dose of an exercise prescription it sounds like would be really great.
Marna
Yeah yeah exactly and yeah.
Dr. Wong
And I think I have to ask this question because as you know I'm really into brain health yeah. Does Lyme affect the brain can it cause like brain fog?
Marna
Oh! Absolutely it's one, that's one of the one of the big signs of Lyme is brain fog and some of the antibiotics cost probably the blood-brain-barrier others may not, but there's things that there's actually some, there's actually a tincture that I give you know just to help.
Dr. Wong
With that.
Marna
And I'm not going to mention this is not a training session.
Dr. Wong
Right, right.
Marna
So I'm not going to talk too much about products but there's definitely things that I give just to help with brain fog.
Dr. Wong
Because Lyme can infect the brain.
Marna
Oh yes! It definitely
Dr. Wong
Can across the blood-brain-barrier.
Marna
Yes, yes. Unfortunately.
Dr. Wong
Well, if you have Lyme you live in the area locally go see Marna. Marna's Lyme expert here at CIH. We're so grateful for your words of wisdom here on really treating all pillars of health.
Marna
Yes.
Dr. Wong
Looking at the entire terrain while also dealing with the microbe that someone might have, like a Lyme or co-infection, so thank you Marna.
Marna
Oh, no. it's great to be here thank you.
Dr. Wong
Yes, and we are actually still on for some closing questions that we do like to ask all of our guests so if you don't mind.
Marna
Okay.
Dr. Wong
We have a question about morning routine. So is that something that you do? Morning routines are really good for health and we're just wondering if you have a morning routine.
Marna
Okay morning routine, ha! yes! I do try and I get up every morning. I mean, I think coming in, I have a commute so sometimes even I try and I don't do this routinely as much as I should. Sometimes even singing in the car sometimes I have this prayer that I just use that's a rote prayer that I can just do every day you know and so that is something that I do to try and help focus you know. Say okay help me focus help me get through this day but it's a, it's a specific one that I used and so that is something that I try and do sort of more in my car as I come in.
Dr. Wong
And of course, you know that singing to songs is a great way to stimulate the vagus nerve.
Marna
I know, so that's why I need to do that one more right? It helps wake you up as well that's a really good one that I need to do more of.
Dr. Wong
And lastly, you know, we know that if all people's Lyme symptoms are quote-unquote solved and their you know symptoms but they don't have joy, we know that this is like a big factor to tell. So kind of, what do you do to cultivate joy in your own life?
Marna
Right. I think for me, I mean, I really, walking, I love to walk you know. I mean I think that really clears my head a lot you know that's probably the exercise I like is more than anything. I also like to bike you know and then I think the really, importance of interpersonal relationships and I really try and keep up with you know family and friends and just it's very important for everybody to have a support system I mean obviously we can have therapy which is often really needed particularly with chronic Lyme and they've been individuals have been dealing with that but even just to be purposeful and developing you know a support system and have positive relationships around you.
Dr. Wong
Yeah, deep positive relationships, connections. It's really key to life.
Marna
Exactly. Right, yeah, and faith you need to have faith you know that there is somebody watching out for you.
Dr. Wong
Yeah, yeah that's great and we should actually, I think we should definitely talk about basketball as well I know that's another family of your exercise.
Marna
Yes!
Dr. Wong
Keeping up with the teenagers.
Marna
Right right right and Rock Chalk KU my team!
Dr. Wong
That’s right. Alright.
Marna
Won the national, NCAA tournament this year.
Dr. Wong
Well, congrats to Marna and Jayhawks this year 2022. Thank you so much Marna for coming on today.
Marna
Yeah, I do, I and that is one thing I do for exercise, I love it. I go to a great school near me that has a basketball court. I mean you know not in session, I can't do it all the time but I love to just to go play basketball because I like that better than running because you know you sure don't make the shots all the time so you have to run back and catch your, you get exercise that way and you use different muscles with shooting and stuff so I love to go shoot baskets.
Dr. Wong
Well if you don't make it the first time just keep shooting the ball.
Marna
Right. I know. I have my sweet spot. I'd like to just do it so.
Dr. Wong
Awesome.
Marna
It's great.
Dr. Wong
Well, thank you so much again Marna for coming on great to see you here.
Marna
All right, thank you.
Dr. Wong
Thank you.
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