Saboteurs - · 2018-04-09 · T.C.’s Saboteurs •Lyme disease •Bartonella •Babesia •Mold Biotoxin disease “CIRS” •Methylation: MTHFR / COMT •B12 Deficiency •Genetic

Saboteurs

In Orthopedic MedicineJanine Talty, D.O., M.P.H.AAOM Clearwater Florida

April 19-22

T.C.’s Saboteurs

• Lyme disease

• Bartonella

• Babesia

• Mold Biotoxin disease “CIRS”

• Methylation: MTHFR / COMT

• B12 Deficiency

• Genetic SNP’s

• Hormone Dysregulation

• Viruses

• Adrenal Insufficiency

• POTS Syndrome

• Diabetes Insipidus

• Parasites

• Alpha-Galactose Allergy

8/28/2017 T.C. a 6’ 2” 175 lb 53-year-old white male who was involved in a head-on MVA in 2001 who presented at the time with a primary compliant of Right L5/S1 radicular pain that failed multiple conservative treatments, pain management injections and finally underwent a laminectomy of L3/4 in 2015. The surgery stopped his leg pain for 3 months and then it returned. He underwent three repeat lumbar epidurals, two selective nerve root injections along with a series medial branch blocks with neurotomy. He eventual underwent a follow up MRI which did not demonstrate scar tissue formation as the doctors involved had postulated. In 2014, he was seen by one of our AAOM members who thought that the pain might be referred from the ligaments of the pelvis and sacrum. He then underwent six PRP and stem cell treatments. Two days after each treatment he experienced very unusual side-effects; nausea, vomiting, bloating, severe diarrhea and bloody stools. He was admitted to the hospital for severe dehydration one month after the first treatment, but proceeded with the next five PRP/Stem cell treatments over the next several months despite the obvious signs his body was rejecting the therapy demonstrating the same unusual reaction to the treatment. He was equally sick after each treatment and none of the treatments help his pain. He was also experiencing “missing time” episodes, he drove from NC to WV, arrived at his mother’s home and could not recall how he got there or why he came. Since the initial presentation in 2001, his symptom had become multi-systemic. By the time I saw him they included:

Fifteen- year history of chronic right upper quadrant abdominal pain with three negative Gallbladder ultra sounds and no definitive diagnosis

Severe Right leg pain that followed the L5/S1 dermatome Right leg weakness where the leg continued to give out where he continues to sustain multiple falls Chronic upper and lower extremity muscle, joint, facial and tendon pain Plantar fasciitis; cannot put full weight on feet and uses a cane to walk Chronic fatigue; cannot be out of bed for more than ½ hour or walk to his mail box Loud tinnitus Special sense hypersensitivity Dizziness Peripheral neuropathy diagnosed with biopsy showing small fiber neuropathy B12 Deficiency Skin hypersensitivity (hypoesthesia) History of Bell’s palsy Muscle fasciculation’s Tremors of the upper and lower extremities Jerks while falling asleep at night and while at rest

Temporal /frontal headache Recurrent painful facial rash that responded to three separate courses of Doxycycline Autonomic neuropathy symptoms; orthostatic, heart rate variability, arrhythmia’s, POTS

symptoms Extreme urination up every two hours at night Severe cognitive impairment; short and long-term memory loss, word-finding problems,

confusion, slow mental processing time, loss of executive function, dropped thoughts and missing time episodes

Severe emotional changes; rages, depression, anxiety, withdrawn, suicidal along with bipolar symptoms

Soaking night sweats Dark urine A life-long history of asthma and allergy symptoms managed with allergy shots Recurrent chronic sinusitis Chronic diarrhea 50-pound weight loss, can only eat bland soup at this point Eating red meat makes him nauseated with diarrhea and increase generalized pain

Some Background:

He owns and runs 5 separate energy and real estate development companies, in 2015 traveled 48 weeks per year on business in 5 countries in Europe and South America. He vacationed frequently in Mexico. In 2016 was only able to travel 13 weeks that year and by 2017 was home in bed 49 weeks. He grew up the son of a coal miner in West Virginia with a life-long history of at least 75 tick bites and a recent Loan Star tick bite and a history of a spider bite in 2006 that produced an 8 cm round painful rash on his forehead that lasted 3 weeks. He grew up swimming in streams and ponds.

Along the way he was seen by a total of 17 doctors in the specialties of: Rehabilitation (2)Pain Management (3)Neurology (2)Internal MedicineGastroenterologist (3)Hospitalist’s (2)Dermatologist (2)Audiology (who ordered a Lyme test based on the results of his findings and referred him to ID)Infectious disease

The Testing Sucks

Testing Controversy

• CDC requires a two tier testing criteria

• ELISA and if equal to or >0.91 then a Western Blot

• Commercially available kit has low sensitivity and specificity that all the “regular” labs use (do not include 31, 34 K-dal bands: LymeRx vaccine)

• IGene-X test has a sensitivity and specificity of 98% (they include 31, 34)

• Lyme specific Bands: 23–25, 31, 34, 39, 83-93

• Bands that cross-react: 18, 28, 30, 41, 45, 58, 66, 73

Numbers Vary: Two Tier TestingSensitivity = True Positives / Specificity = True Negatives

• Dressler et al. 1993 All agreed the sensitivity of the two-tier

• Bacon et al. 2003 is low ranging from 29% - 45%

• Aguero/Rosenfeld et al. 2005

• Branda et al. 2010

• Wormser et al. 2013

• Molins et al. 2016

Different in Different Presentations

• In Acute Disseminated NEUROLOGIC presentations: 21% +

• In Lyme ARTHRITIS Sensitivity is 97% - 100% +

• It depends on where in the course of the disease the person is tested

• Columbia: with chronic symptoms and previous treatment only 10% +

• In early Lyme false negative is 60% - 70%

• Meaning…It will only find it 30% - 40% of the time!

CDC Criteria

• Bull’s Eye rash (all by itself no serologic test needed)

• Positive or Equivocal ELISA test = >.91

With

• Must have 2 of the 3 IgM bands: 23, 39 or 41

OR

• 5 of the 10 IgG bands: 18, 23, 28, 30, 39, 41, 45, 58, 66, 93

What Do The K-dal Bands Mean?

• 18: Flagellum Fragment

• 21: OspC

• 22: Immunogenic integral membrane lipoproteins

• 23-25: Outer surface protein C (OpsC)

• 28: Outer surface protein D (OpsD)

• 30: OpsA substrate binding protein

• 31: Outer surface protein A (OpsA)

• 34: Outer surface protein B (OpsB)

• 37: Flagellum A gene product

• 39: Bacterial membrane protein A

• 41: Flagella

• 45: Heat shock protein, appears for Ehrlichia

• 58: Heat shock protein

• 66: Heat shock protein, outer/integral membrane

• 73: Heat shock protein

• 83: High molecular mass protein

• 93: Immunodominant protoplasmic cylinder antigen associated with the flagellum

Drag picture to placeholder or click icon to addWestern BlotDrag picture to placeholder or click icon to add

T.C’s Western Blot

“

”

What’s Your Diagnosis Docs?

Lyme Disease?

• Not according to the Infectious Disease Doc

• Right Leg Radicular Pain• Lyme disease• Bartonella• Babesia• Mold Biotoxin disease “CIRS”• Hormone Imbalance/dysregulation• Adrenal Insufficiency• Hypogonadism • A-kinetic gallbladder (positive HIDA scan)• Parasites (proven by treatment trial)• B12 Deficiency• MTHFR deficiency in both the C677T and both COMT snips (worst combination). Cannot use B12 to methylate at all• Genetics testing showed Multi-Susceptible to mold and other neurotoxins/Chronic Fatigue/Mold Susceptible• POTS (due to mold)• Diabetes Insipidus (due to mold, lack vasopressin)

My Diagnoses

Lyme Disease300

Different Symptoms• All Characteristically come and go and migrate

Multi-Systemic Illness(Symptoms Come and Go and Migrate)

• Fatigue• Musculoskeletal System: joints, muscle, tendon, fascial, spine,

discogenic pain• Neurologic: central/autonomic/peripheral/special sensory• Psychiatric/Mood/Behavioral• Gastrointestinal• Cardiac• Dermatologic• Genitourinary• Hormonal/Endocrine• Obstetrical

Common Symptoms of Lyme Disease

• Fatigue Loss of Libido

• Weakness Menstrual Irregularities

• Joint Pain Sweats (day and night)

• Muscle Pain Temperature Dysregulation

• Fascial Pain Thyroid Dysfunction

• Peripheral Neuropathy Pituitary/Adrenal Dysfunction

• Special Sense Hypersensitivity Appetite Swings

• Radicular Syndromes Excessive Weight Gain/Loss

• Lower Extremity Paralysis Rashes

• Discitis Head Aches

• Neck Pain/Back Pain Irritable Bowel Symptoms

• TMJ Sleep Disturbance

•Dizziness/Vertigo

•Tinnitus• Morning Stiffness

•Memory Issues •Mood Swings•Bipolar Symptoms

•Focus/Concentration Issues

•Word Recollection Issues

•Decreased Learning of New Knowledge

•Confusion •Disorientation •ADHD/ADD/Autism/Dyslexia

•Dementia

You Suspect Lyme Now What?

• So Now What?

• “It’s a CLINICAL DIAGNOSIS”

Lyme Labs 101

• ELISA/ IFA

• Western Blot (Lab Corp, Quest vs. IGene-X)

• HLA-DR4 (31, 34 Kdal bands Lyme Vaccination)

• C6-ELISA

• CD57 (long-term marker in persistent Lyme)

Normal is 60-360. If less than 60 = Lyme disease

Every 10 lower than 60 is a decade of having had the disease

Xenodiagnoses

• Hodzic et al. 2008

• Embers et al. 2012

• Marques et al. 2014

Persistence!

• Previously treated mice, rhesus macaque and now human with chronic symptoms….?

Laboratory raised ticks can feed and find spirochetes and DNA evidence in the previously clear ticks

The Sixteen Things That You Have to Consider in Order to

Fully ~Recover~

Lyme is a Systemic Illness

MSIDS• Bacteria

• Viruses

• Parasites

• Fungus

• Immune Dysfunction

• Inflammation

• Environmental Toxicity

• Allergies

• Nutritional Deficiencies

• Enzyme Deficiencies

• Mitochondrial Dysfunction

• Neuropsychiatric Issues

• Autonomic Dysregulation

• Endocrine Abnormalities

• Sleep Disorder

• GI Disturbance: (IBS)

• Abnormal Liver Function

• Pain

• Drug Use

• Physical Deconditioning

• VERY CONTROVERSIAL!

• Many options: chronic -vs- acute

• Long-term antibiotics are safe and effective

• Herbal protocols are safe and effective

• Perfect storm for “Integrative Medicine”

• No two people have the same disease

• No one gets better the same

• Strict guidelines have no role

• Doing nothing should not be an option

Treatment?

Antibiotics• Doxycycline (200 mg twice a day)

• Amoxicillin/Clavulanic Acid (Augmentin 875 mg twice a day)

• Azithromycin (Zithromax 500 mg once a day)

• Clarithromycin (Biaxin 500 mg twice a day)

• Cefuroxime (Ceftin 500 mg twice a day)

• Ceftinir (Omnicef 300 mg twice a day)

• Clindamycin (300 mg twice a day)

• Metronidazole (Flagyl 500 mg twice a day)

• Minocycline (100 mg twice a day)

• Tetracycline (500 mg three times a day)

• Alinia (500 mg twice a day)

• Bicillin LA ( 1.2 MU IM injection 1- 3x/week)

• IV Rocephin (2 grams twice a day)

• IV Doxycycline (400 mg once a day)

• IV Azithromycin (500 mg once a day)

Intracellular Antibiotics

• Doxycycline

• Biaxin (Clarithromycin)

• Zithromax (Azithromycin)

• Minocycline

• Tetracycline

• Rifampin

• Alinia

• Bacrim

• Penicillin's

• Amoxicillin + Clavulanate (Augmentin)

• Ceftin (Cefuroxime)

• Omnicef (Cefdinir)

• Clindamycin

• Rocephin IV

• Bicillin-LA

Cell Wall Antibiotics

Combination Therapy(Oral)

Extra Cellular Drug with an Intracellular Drug:• Ceftin / Omnicef with Biaxin / Azithromycin / Rifampin

• Doxycyline with Augmentin

• Doxycycline / Biaxin / Azithromycin with Omnicef / Ceftin / PCN

• Flagyl for cyst or round-body forms

• PCN allergic use Clindamycin instead

Parenteral Treatments(All cross the blood brain barrier)

• Cephtriaxone (Rocephin) 2 grams IV BID

• Azithromycin 500 mg IV q day

• Doxycyline 250 mg IV q day

• Clindamycin 900 mg IV TID

• Bicillin LA 1.2 MU IM q weekly or twice a week

Herbal Protocols

•Buhner Protocol Stephan Buhner.com Healing Lyme; vol. 1 & 2 Stephan Buhner

•Green Dragon Botanicals.com

• Take 4 capsules 4 x /day with food x 9 months

(only Lyme)

•Cowden Protocol (treats Lyme and all co-infections)

• NutraMedix.com 9 month protocol

(

• T

• Klinghardt Liposomal Herbal Protocol Hyaluronic Acid 10 minutes before a cocktail of the rest:

BioPure Cocktail tincture

BioPure Cistus Incanus tincture

BioPure Cilantro tincture

Ionic Foot Bath

• May add A-Bart or A-Bab

•Essential Oils•Homeopathics•Whole Leaf Stevia Extract•EPFX/SCIO•Hyperbaric Oxygen Therapy•Rife

Other Effective Treatments

• Flour• Sugar: (Including Tropical Fruit)• Corn• Potatoes • Rice • Alcohol• Other Grains and Cereals• Dairy

Foods To Avoid

Supplements To Take

• Co-Q10

• Alpha Lipoic Acid

• D-Ribose / Galactose

• Fish Oil (pharmaceutical grade)

• Vitamin D3

• Increase Good Fats in the Diet (MCF)

• High Dose Vitamin C

• Glutathione Gel SL

• Echinacea/Golden Seal

• Magnesium

• Liposomal Curcumin

• Probiotics (“billions and billions” …Carl Sagan)

• Glutathione• High Dose Vitamin C• Alpha Lipoic Acid• Curcumin• Hydrogen Peroxide• Myer’s Cocktail• Chelation for Heavy Metals

IV Treatments

The Number One No…No!!

Steroids

Co-Infections• Bartonella: “Cat Scratch Fever”• Babesia: Cousin to malaria• Ehrlichia/Anaplasmosis:

• (Same symptoms as Lyme Disease)

BartonellaIntracellular Bacteria

•Day sweats – intermittent•Lymph nodes that come and go•Tendonitis•Fasciitis (plantar fasciitis)•Knife-like stabbing head aches behind the eyes•Severe cognitive dysfunction: dementia symptoms•Memory loss: short-term and sometimes long-term

• Confusion: loss of time disorientation in space

• Rashes: stretch marks, lace-like, vasculitis, cherry angiomas

• Peripheral neuropathy

• Long bone/shin pain

• Nodules in fascial planes triceps and lateral thighs

• Sleep Disturbance

Treatment for BartonellaIntracellular Bacteria

• Fluoroquinolones: Cipro 500 mg BID or Levaquin 750 mg q day

• Bactrim 500 mg with Rifampin 300 mg (empty stomach)

• Doxycycline 200 mg BID with Azithromycin 250 mg q day or Biaxin 500

mg BID

• Plaquenil 200 mg BID with Doxy/Azithromycin /Rifampin

• Can mix any 3 intracellular drugs together

• Herbs: A-Bart or other combinations

BabesiaIntracellular Parasite

• High fever at infection onset >101* F• Falciparum parasite: Cousin to malaria• Soaking night sweats• Dark urine• Intermittent shortness of breath• Cardiac arrhythmias• Chest wall pain• Severe joint, GI & muscle pain• Middle of the head pain• Sense of pressure in the head

Treatment for BabesiaIntracellular Parasite

• Mepron: 750 mg/5 ml BID with fatty food

• Malerone: 250 mg BID (if Mepron is too expensive)

• Azithromycin: 250 mg or Biaxin 500 mg BID with Mepron or Malerone

• Plaquenil: 200 mg BID

• Alinia: 500 mg BID

• A-Bab: titrate 2-20 drops BID 30 minutes before breakfast and dinner

• Herbs: See Buhner Healing Lyme volume 2

Ehrlichia• Can have sudden onset that looks like shock

• Chronic Global Headache

• Liver enzyme elevation for no other reason

• Low platelets

• Low WBC count

• Symptoms otherwise very similar to Lyme disease

Labs for Co-Infections

• Bartonella Henselae/Quintana AB’s (28 additional species=no tests)

• Ehrlichia AB’s

• Babesia Microti & Duncani/WA-1 AB’s (28 additional species=no test)

• VEGF (if <40 its mold, if >86 its Bartonella)

• Borrilia Hermsii AB’s

• Borrilia Miyamotoi AB’s

Mold Biotoxin Disease?IT ‘S GENETIC

¼ of the Population Is Susceptible

The Same People Who Get Sick From Lyme Disease Are the Same People

Who Get Sensitized To Mold(Complex Inflammatory Response

Syndrome)

“CIRS”

• There are so many possible sources of these toxic compounds found in WDB (water damaged building) that can lead to the variety of the symptoms caused by mold illness, no single compound can be identified as the sole cause of the inflammatory response, or the illness, seen in affected patients. Since no one thing can be deemed solely responsible for the sickness, the sole cause becomes the WDB

50% Of All Buildings In The USA

Any Interior Water Damage to a Building Can Grow Toxic Molds

Mold Biotoxin Symptoms• Fatigue Red Eyes

• Weakness Blurred Vision

• Aches Visual Changes

• Muscle Cramps Tearing

• Joint Pain Sinus Problems

• Unusual Pain Cough

• Morning Stiffness Shortness of Breath

• Peripheral Neuropathies Sweats

• Tremors / Jerks / Facilitations Diarrhea

• Headache Abdominal Pain

• Light Sensitivity / Auditory Hypersensitivity

• Memory Issues

• Focus/Concentration Issues

• Word Recollection Issues

• Decreased Learning of New Knowledge

• Confusion Temperature Regulation

• Disorientation Metallic Taste

• Mood Swings Appetite Swings

• Skin Sensitivity Excessive Weight Gain

• Excessive Thirst

• Sleep Disturbance

How Can You Tell The Difference?

Both Are Neurotoxins

• The Labs For Mold ARE Reliable• VCS Test SurvivingMold.com

• Must Treat Mold FIRST!

• MSH = <35 (or >75) Long-Term Marker

• C4a = > 2,830 Short-Term Marker

• TGF-Beta-1 = > 2,380 Short-Term Marker

• MMP-9 = >332 Long-Term Marker

• VGEF = <40 Long-Term Marker

• Leptin = Male: 0.5-13.8 HLA-DR-B1, 3, 4, 5, DQ

Female: 1.1-27.5 Vasopressin <2.0

Labs For Mold Disease

M o l d L a b & W h a t T h e y M e a n( G o t o Ji l l C a r n a h a n . c o m a n d l i s t e n t o m o l d t a l k s f o r m o r e i n f o r m a t i o n )

C 4 a = split complement inflammatory cytokines = trigger inflammation

M M P 9 ( i f e l e v a t e d ) = causes fibrosis of lungs and other tissues

M S H ( i f s u p p r e s s e d ) = is due to the colonization of nasal and sinuscauses a complete disruption and dysregulationof the endocrine system and massive gutpermeability linked to leaky gut, Crohn’s andcolitis

A D H ( i f s u p p r e s s e d ) = diabetes insipidus increased thirst and increasedvery dilute urination

L e p t i n / A d i p o n e c t i n ( i f e l e v a t e d ) = sudden onset of weight gain withoutA known obvious cause (up to 30 lbs. in a shorttime)

T G F - B 1 ( i f e l e v a t e d ) = sign of over-active immune system and drives upTh-17 which drives up T-reg cells that act as thepolice of your immune system that keeps thingsfrom over-reacting which drives autoimmunity

V E G F ( i f s u p p r e s s e d ) = causes capillary hypo-perfusion which leads toexercise intolerance as capillaries cannot deliveroxygen to the tissues this leads to musclecramping due to cytokine release andinflammation

A n t i - G l i a d i n A B = can be elevated associated with gluten sensitivity andmore gut inflammation

The Biotoxin Pathway In genetically susceptible people, biotoxins bind to pattern receptors,

causing continuing, unregulated production of cytokines.

Surface Receptors

(Toll; C-type lectin;

mannose & others)

Dendritic Cells

HLA-DR

High cytokine levels in the capillaries attract white blood cells, leading to restricted blood flow, and lower oxygen levels. HIF stimulates VEGF and TGF B-1. Reduced VEGF leads to fatigue, muscle cramps, and shortness of breath (may be over-ridden by replacement with erythropoietin). TGF B-1 changes cell type and interacts with Treg cells.

Capillaries HIF

Immune System Symptoms

Patients with certain HLA genotypes (immune response genes) may develop inappropriate immunity. Most common are antibodies to: -Gliadin (affects digestion) -Cardiolipins (affects blood clotting) Treg cells: Pathogenic T cells

Split Products of Complement Activation

C4a: capillary hypoperfusion C3a: bacterial membranes

Increased Cytokines

High levels of cytokines produce flu-like symptoms: Headaches, muscle aches, fatigue, unstable temperature, difficulty concentrating and more. High levels of cytokines also result in increased levels of several other immune-response related substances, including TGF B-1, MMP-9, IL-1B, and PAI-1. MMP-9 delivers inflammatory elements from blood to brain, nerve, muscle, lungs, and joints. It combines with PAI-1 in increasing clot formation and arterial blockage.

Inflammation-related symptoms

Resistant Coag-negative Staph Bacteria

Colonies of MARCoNS with resistance to multiple antibiotics may develop in biofilm or mucus membranes. The bacteria produce substances that aggravate both the high cytokine levels and low MSH levels.

Reduced ADH Reduced MSH can cause the pituitary to produce lower levels of anti-diuretic hormone (ADH), leading to thirst, frequent urination, and susceptibility to shocks from static electricity.

Hypothalamus

VIP MSH

AVP

Leptin receptor

Reduced MSH

Fat cells then produce more leptin, leading to obesity (which doesn’t respond to exercise and diet).

Damaged leptin receptors lead to reduced production by the hypothalamus of MSH, a hormone with many functions.

Excessive cytokine levels can damage leptin receptors in the hypothalamus.

Reduced Androgens

Reduced MSH can cause the pituitary to lower its production of sex hormones.

Changes in Cortisol and ACTH levels

The pituitary may produce elevated levels of cortisol and ACTH in early stages of illness, then drop to excessively low levels later. (Patients should avoid steroids such as prednisone, which can lower levels of ACTH)

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In most people, biotoxins are either removed from the blood by the liver or attached by the immune system, broken down, and excreted harmlessly. In people who don’t have the right immune response genes, however, biotoxins can remain in the body indefinitely.

Nerve cell/axon

Biotoxins have direct effects, including impairment of nerve cell function.

Sleep Disturbance

Production of melatonin is reduced, leading to chronic, non-restorative sleep.

Chronic Pain

Endorphin production is suppressed. This can lead to chronic, sometimes unusual, pain.

Gastrointestinal Problems

Lack of MSH can cause malabsorption in the gut, resulting in diarrhea. This is sometimes called “leaky gut” and resembles (but is not) celiac disease. IBS is often present.

White blood cells lose regulation of cytokine response, so that recovery from other illnesses, including infections diseases, may be slowed.

Prolonged Illness

c R. Shoemaker, 2011

Missing the Arms and Catchers Mitts

Hormone Dysregulation

• TSH (<2.0 or don’t care)

• Free T3 (3.7-5.0)

• Reverse T3 (<20)

• TPO

• Thyroglobulin AB’s

• AM Temps x 3 (>98.0)

• Pregnenalone (>100)

• DHEA (Men=>450, Women=>250)

• Estradiol Menopausal (80-100)• On day 12 Menstruating (60-260)

• Progesterone (On Day 21 = 18-25)

• Free Testosterone Men = >200• Women = >5.0

• Get out of the exposure immediately and don’t take anything with you!

• Fine mist whole house spray balm enzyme disruptor kills mold permanently and penetrates contents

• Detox, Detox, Detox….Did I mention DETOX!

• Re-build Your Immune System

________________________________________________

• Glucamonnan 2,000 mg 3x/day empty stomach

• Zeolite ¼ tsp in 4 oz. in water 3 x/day empty stomach

• Cholestyramine one scoop 3 x/day empty stomach

• Klair Labs: Interfase Plus Enzymes 3 x/day with food

• Whole Leaf Stevia Extract 30 drops 2x/day (also kills Lyme)

• Xylitol Spray 4 sprays each nostril 2x/day

Treatment?

Potential Food Sources

Milk, cheese, eggs, meat (contaminated feed), cereals, wheat, spices, tree nuts, peanuts, pistachios, Brazil nuts, chilies, oilseeds, corn, spices, black pepper, dried fruit, figs , dr ied coconut

Cereals, wheat, corn, oats, coffee, dried fruit, wine, beer, cocoa, nuts, beans, peas, bread, rice, cheese, meats (contaminated feed, especially pork and poultry), dried and smoked fis

h, soybeans, gar banzo beans

Grains, cereals, wheat, barley, oats, corn, rye, durum, soybeans, potatoes, sunflo

w

e r seeds, peanuts, bananas

This table is a partial listing of organisms that may produce mycotoxins. The focus is on the specific mycotoxins tested via urinary mycotoxin testing from RealTime Laboratories. Additional sources of mycotoxins or mycotoxin binders may not be listed in this table. Some of the binders mentioned above are from veterinary literature, as mycotoxins are a serious concern in the production of animal products such as milk, eggs, and meat.

Mycotoxin

Afla

t

oxi n

Ochratoxin

Trichothecene

Associated Molds

• Aspergillus fla

v

us• Aspergillus parasiticus

• Aspergillus albertensis• Aspergillus alliaceus• Aspergillus auricomus• Aspergillus carbonarius• Aspergillus niger• Aspergillus ochraceus• Aspergillus sclerotiorum• Aspergillus sulphureus• Aspergillus wentii• Penicillium nordicum• Penicillium viridicatum• Penicillium verrucosum

• Cephalosporium• Fusarium • Myrothecium• Stachybotrys• Trichoderma• Trichothecium• Verticimonosporium

Example Binders

• Clays (bentonite, montmorillonite)• Charcoals• Zeolites• Glucomannan• Diatomaceous earth

• Cholestyramine• Zeolites• Glucomannan• Diatomaceous earth

• Clays (bentonite; montmorillonite)• Charcoals• Zeolites• Glucomannan• Diatomaceous earth

“

”We Are Big-World

Folks?•

• METHYLATION = “SNP’s”• What do we care?

What Is a SNP Anyway?

• Single Nucleotide Polymorphism

• Single changes that occur in any portion of the DNA that alter the way the DNA functions

• The MTHFR mutation is a SNP

Methylmelonic Acid CycleCheck a Homocysteine Level = 6 - 8

Gene & Variation rsID Alleles Result

COMT V158M rs4680 AA +/+

COMT H62H rs4633 TT +/+

COMT P199P rs769224 GG -/-

VDR Bsm rs1544410 CT +/-

VDR Taq rs731236 AG +/-

MAO A R297R not found n/a not genotyped

ACAT1-02 not found n/a not genotyped

MTHFR C677T rs1801133 AA +/+

MTHFR 03 P39P not found n/a not genotyped

MTHFR A1298C rs1801131 TT -/-

MTR A2756G rs1805087 AA -/-

MTRR A66G rs1801394 GG +/+

MTRR H595Y not found n/a not genotyped

MTRR K350A rs162036 AA -/-

MTRR R415T rs2287780 CC -/-

MTRR A664A not found n/a not genotyped

BHMT-02 rs567754 CC -/-

BHMT-04 not found n/a not genotyped

BHMT-08 not found n/a not genotyped

AHCY-01 not found n/a not genotyped



CBS C699T rs234706 GG -/-

CBS A360A not found n/a not genotyped

CBS N212N not found n/a not genotyped

SHMT1 C1420T rs1979277 GG -/-

Name: Terio ComeroseProfile: Methylation ProfileGenerated: 1/30/2018

Methylation Profile generated by GeneticGenie.org Page: 1 of 6

High Homocysteine

• If it is MTHFR C677T = Methylated B12 with Methyl Folate one BID

• If it is the COMT’s = Adenosyl-Hydroxy B12 one BID

Parasites

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Treatment for Parasites

• Albendazole: 400 mg BID x 28 days followed by a 14 day period off repeat x 2

• Stromictal: 15-24 kg: 3 mg PO once

25-35 kg: 6 mg PO once




>80 kg: 200 mg/kg PO once

• Herbal Protocols: Hulda Clark’s Liver and Parasite Cleans

• Goat and Cow Dewormers? Safe-Gard Drench / Valbazen Drench (goat dosages)

Resources• SurvivingMold.com = Dr. Richie Shoemaker

• ILADS.org = Treatment Guidelines

• IgeneX.org

• Under Our Skin: DVD documentary

• Emergence: DVD 7-year follow-up to Under Our Skin

• Cure Unknown: Pamela Weintraub

• Compendium of Tick Born Illness: K. Spreen, DO

• Why Can’t I Get Better: Richard Horowitz, MD

• How Can I Get Better, Richard Horwitz, MD

• Conquering Lyme Disease: Fallon & Sotsky

• Healing Lyme Disease: Stephen Buhner, ND

• The Lyme Times: Vol. 24, Number 1

• Lyme Disease Solution: Kenneth Singleton, MD

• Lab 257: Michael Carroll, JD

• Pathways to Recovery: Amy Yasko, MD

Documents

Saboteurs - · 2018-04-09 · T.C.’s Saboteurs •Lyme disease •Bartonella •Babesia •Mold Biotoxin disease “CIRS” •Methylation: MTHFR / COMT •B12 Deficiency •Genetic