BAL Spotlights Series
In this article transcribed from our Distinguished Speaker Series webinar, Sunjya Schweig, MD, founder and CEO of the California Center for Functional Medicine and member of Bay Area Lyme’s Scientific Advisory Board, discusses how recovering from tick-borne illnesses can be aided through carefully devised combinations of conventional and functional medicine, tailored to the individual person. Nancy Chimsky, retired interior designer and Lyme patient, who has been challenged with tick-borne infections since 1997, shares her personal Lyme story in the first part of this webinar.
Dr. Schweig discussed the top four lifestyle areas critical to aiding recovery and explains how and why optimizing each area is key to treating and managing Lyme and tick-borne disease. The lifestyle areas are:
- Diet and nutrition
- Stress reduction and neuroplasticity
- Sleep
- Detoxification
Dr. Schweig also discussed the important role that botanical and herbal medicines have in recovery. He discusses the individualized nature of treatment and testing for Lyme disease, including the use of various lab tests and the consideration of co-infections. Finally, Dr. Schweig emphasizes the importance of finding the right healthcare practitioner who can address the complexity of Lyme disease and provide appropriate treatment. The session concludes with a Q&A session about what people are doing to manage their health, and Dr. Schweig provided practical suggestions and concrete takeaways based on these questions from attendees.
Linda Giampa, Executive Director of Bay Area Lyme, hosts the conversation.
Linda Giampa: Hello everyone and thank you for joining us. In our webinar today, we will be hearing from our first panelist, Nancy Chimsky, Lyme patient and Bay Area Lyme supporter. She will be sharing her personal Lyme journey with us.
Our second panelist is Dr. Sunjya Schweig who I have known for 10 years. He’s a long-term member of our Scientific Advisory Board and the CEO of the California Center for Functional Medicine. They’ll both be speaking to you tonight. We are happy to host these events and it’s heartening to all of us here at Bay Area Lyme to bring the Lyme community together and to help in any way we can.
Bay Area Lyme is a patient-focused research foundation. We’re national and many of you here watching are from all around the country. If you have received this invitation, then you are on our newsletter list. Our newsletter is published each quarter, so look for it. It has updates on our research activities.
We also host speaker series and webinars throughout the year. We post recordings of our online events in our video gallery and we also have many helpful videos about Lyme and tick-borne diseases, so please visit. In addition, we have a video podcast series Ticktective that currently has over 20 video podcasts that are from interviews with Lyme researchers, doctors, patients, and caregivers in our Lyme community that are extremely helpful.
At the end of this blog, we have links to our Ticktectives and our videos, as well as this webinar. We will get to the questions at the end of Sunjya’s talk and have a Q & A session. So, with that, I am going to turn it over to our patient speaker this evening, Nancy Chimsky, and I will see you later. Thanks.
Nancy Chimsky: Hi everyone. First, I want to thank all of you for joining us this evening. I was scheduled originally to speak in March of 2019 and unfortunately, I was unable to due to a very severe Lyme flare up that led to three and a half years of being bedridden. So, tonight has been long-awaited and fulfilling this goal is very important to me. I appreciate you being with us and for all of your support. It’s an honor and a privilege to be able to share some of my journey of living with chronic Lyme disease for the past 26 years. I hope that through sharing some of my experiences, I can be helpful to others who feel very misunderstood and experience the lack of available treatments effective for this very challenging and very insidious disease.
First, I will give a little history: In 1958 at the age of two, I started to have health issues that involved chronic bladder and frequent bladder infection issues and chronic kidney issues. Multiple surgeries and about 12 years of invasive treatments—along with long-term doses of antibiotics—brought on allergies to these medications and some terrible side effects.
At 15 years old, I was diagnosed with mononucleosis more commonly today called the Epstein-Barr virus or EBV. Penicillin was prescribed and I had a very severe reaction to it. In my twenties and thirties, I continued to have reactions and a lot of allergies to many other forms of antibiotics.
After having EBV, my immune system was considerably compromised. I caught colds easily. I had chronic bronchitis and, of course, a lot more antibiotics were prescribed. I had more adverse reactions and a continual dwindling of the medications in the antibiotic families that I could tolerate.
So, super fast forward, my wonderful supportive husband Rob and I were married in 1994. I was 38 years old and still hoping to conceive even though I knew my fertile years were declining. We were transferred from the Bay Area to Seattle at the end of 1995, and two months later, we were informed that we needed to move again—to the other Washington: Washington DC.
15 months later we moved to Northern Virginia. We had a new home built. It was in a development that was previously a forest with a significant deer population and common rodents. Frequent contact with ticks occurred from my daily walks with our cocker spaniel and the infestation of ticks was rampant given the prior animal populations in that area.
At the time I was not very familiar with or very educated about Lyme disease. However, I always knew the importance of checking for ticks, so I was checking our dog regularly. I did her grooming. Many ticks did attach to me but I don’t recall ever having a bullseye rash, but I had a tendency to get rashes anyway, so I may not have really recognized a true bullseye rash or any other strong indicators.
Within probably two or three months after moving there, I was experiencing a lot of chronic fatigue, night sweats, sleep disturbances, very intense headaches, severe joint pain, and some of these symptoms I thought could just be the stress of two moves and the fact that I was getting closer to a time where some changes would be taking place in my body with estrogen levels and so I sought medical advice and nothing significant was found other than low estrogen levels.
They figured the fatigue was purely from sleep issues, early onset perimenopause, and something called fibromyalgia, which was not familiar to me at the time. No doctors ever suggested that I should be tested for Lyme disease even though it was already known for over 20 years, and I had many of the common symptoms. I sought chiropractic treatments, massage therapy, some acupuncture, and I had temporary relief. I had all the amalgam in my teeth removed and replaced with porcelain because I had read things about the immune system in general that that could be a good thing to do. I changed some dietary habits like limiting dairy and switching to soy milk or almond milk. It seemed that most of the doctors were very focused on my illness being due to hormonal imbalances and stress from various changes that had occurred in my life.
These symptoms went on relentlessly and worsened over the course of the next several years, but by the mid-2000s, we started to make plans to move back to Northern California. Within a year’s time, we bought a five acre property in Sonoma. That was a major remodeling project that permitted me to engage in my interior design background and I was loving the creative process. But the sad part was I was feeling worse and worse health-wise. I had a lot of adverse reactions to some of the construction debris and later to chemicals that were being used—like adhesives during installations, especially with flooring and cabinetry where they had to use glue that was pretty noxious. Anytime when I was in traffic situations, I started noticing that diesel emissions would make me severely ill and cause instantaneous nausea and headaches, and I started to always have towels in the car to cover my face so that I was prepared.
I knew it was more than hormone balances, but I could not seem to get doctors to really listen to what I was saying and to get any other tests or diagnosis. For about 10 years, I saw at least a dozen doctors and naturopaths with—at the best—very temporary and minor relief. I had to force myself to hang in there and show up for special occasions, which became increasingly challenging.
Finally, in September 2010, I was referred to a nurse practitioner who was known to help several women and some friends of mine as well with bioidentical hormone treatments. By that time, my cycles had almost completely stopped. The nurse read my history that I filled out and my current complaints and suddenly blurted out, “I think you have chronic Lyme disease and I think you’ve had it for a very long time.” I was literally speechless and that’s really rare for me!
I asked her how and why she would so quickly and with such certainty make that diagnosis prior to any actual testing, and she explained to me that her daughter had been dealing with chronic Lyme for a dozen years or more, and my symptoms and my history were so similar. She just had a very strong feeling. We proceeded to follow up with proper testing through iGeneX that was considered much more accurate at the time. However, I’d had the symptoms for so long, it was difficult to get an exact diagnosis. There were positives, but there were also some borderlines with some of the inconclusive tests, which is not uncommon.
The diagnosis of chronic Lyme led to my just feeling that my world was crashing in. I was very afraid I had heightened anxiety and depression. The little bit of information that I could find in 2010 on the topic aroused my biggest fears and concerns because two things were clear for me: first, there was no actual cure for chronic Lyme and second, the most common treatments involve antibiotics, which I could not easily take. My major challenge ahead was working around my antibiotic allergies and seeing what types of treatments I could tolerate and that would help me from that point forward.
For the first couple of years, very few traditional Western doctors would even acknowledge my chronic Lyme diagnosis. My primary doctor at the time was just adamant that Lyme was being talked about way too much.
It was not easy in the beginning to know where to get help at all. The doctors typically prescribed anti-anxiety, medication, antidepressants, pain medications that were highly addictive and more recently have been totally taken off the market. Fortunately, I didn’t use most of them knowing that the Oxy and Norco category of pain meds was potentially very dangerous and addictive. I did rely on Klonopin for anxiety, but thankfully got off of that fairly soon, which has more recently been talked about as making Lyme patients worse later. Ativan was something I relied on when necessary for anxiety relief, but eventually I ceased taking that as well. It just didn’t feel good for my body. I was quite shocked at the time that California didn’t offer more treatments that didn’t involve mainly long-term antibiotic therapies, sometimes five or six at a time for six months or more. Therefore, I started to explore ways to boost my immune system and balance my hormones to reduce some of those symptoms more naturally.
I sought out numerous methods at great personal expense because most of these treatments and most of these doctors were not covered by insurance. I went to Arizona for a pain management program that utilized meditation and other therapies. I was the only person in the program not addicted to serious pharmaceuticals. In this program, which lasted six weeks, I learned a lot and I felt a little better, but they were still not addressing the chronic Lyme diagnosis for nearly two years. A combination of various methods of managing my health required looking into other possible treatments.
My husband Rob scoured the internet searching for other avenues and it was then that I regained some hope and sought treatment in Petaluma with Dr. Sunjya Schweig who is speaking tonight. This was the very first time I felt I was in good hands. I felt I was being listened to and speaking with a doctor who truly believed all of my symptoms were real.
It was very comforting; it was very emotional and it was a big relief. Not only was Dr. Schweig’s compassionate approach much appreciated, he was able to offer things that I had not been told about before. I did some infusions with a lot of special vitamins that really helped to boost my immune system, a wealth of alternative high-quality supplements and suggestions for ways to manage my health by exercise regimens like yoga or meditation, and it really helped boost my trust and confidence a great deal. At the same time, walking was becoming more challenging. I had to use a cane and my tremors, and my steadiness were really challenging. I needed to bring in caregivers for me due to my husband’s amount of travel with his job.
That was hard because it felt like I had to keep letting go of more and more of my independence.
Dr. Schweig did everything in his ability at the time, but eventually knew and was very honest with me that without some of the antibiotic therapies, we had more or less reached a plateau. But that was in 2014 and a lot has changed.
Another challenge was presented to seek more choices, and so in the late summer of 2015, a medical doctor who was also an acupuncturist in Santa Rosa recommended Sanoviv Medical Institute in Rosarito Beach, Mexico, just south of Tijuana. Again, Rob got on the internet and proceeded to take steps for my first visit to the clinic—I couldn’t even look at a computer screen. My senses were so sensitive and dealing with any of the details was impossible. My brain could not work that way. I had such terrible brain fog.
When I arrived at Sanoviv in September of 2015, I was extremely frail. I weighed under a hundred pounds. I was in a wheelchair. I was very scared, but at the same time, very hopeful because they actually had a program treating Lyme disease that was very comprehensive. The facility was amazing. It offered a hospital setting as well as rooms where you would live in the other section of the building, a spa area, healing pools, educational presentations, psychological support, and an amazing team of doctors who actually communicated with each other on a daily basis and with each other for each and every case. This felt like the answer I had been seeking for years, and once there I was immediately immersed into a daily regimen from seven in the morning until five for dinner. Of course, we broke for lunch, but it was very intense and very good.
They also had excellent gluten-free non-GMO, healing foods that were delicious, and they had treatments that were not typically offered or easily found in the US, especially under one roof. There was detoxification that I went through and then followed by infusions to really boost my health. Not that much different from the ones that I had in Petaluma with Dr. Schweig, but I also had a few other things that were not available in California that I knew of: Blood cleansing with UV and ozone, hyperbaric oxygen tanks, the hypothermia treatments, and I also personally tried using my own blood. It was made into a special plasma treatment, and I did injections for several months, a few times a week. I also tried their stem cell therapy. The first time the stem cell therapy was great. The second time I really didn’t notice much difference. I wish I could say that one course of treatment did the trick, but I can’t. It’s been an ongoing constant battle with remissions and setbacks.
Right now I’m in a really great dormant phase with chronic Lyme. I have some symptoms, but they’re manageable and I’m functioning, which is great. I’ve had a myriad of ever-changing symptoms that many of you can probably relate to who have struggled with Lyme or chronic Lyme. This resulted in almost annual visits to Sanoviv for me to maintain my health and rejuvenate myself after flare ups. It’s a consistent process of trial and error, given the changing effects of how chronic Lyme presents itself and shows up very unexpectedly sometimes. But I feel I am proof at 67 years old and after 26 years of battling this vicious disease that I can promise there is life after being diagnosed with Lyme disease. There is continuing hope that more research with organizations like Bay Area Lyme Foundation and caring doctors like Sunjya Schweig will make my story hopefully less common and treatments more readily available.
Thank you for your time and your support and interest and hopefully it’s helped some of you. And if I can answer some questions later, I’ll be more than happy to.
Linda Giampa: Thank you, Nancy. Thank you so much. That was lovely. I want to call out Rob who’s there in the background as the caregiver. Rob, if you want to step forward and wave to everyone, we’ve been seeing you sort of go in and out. Wonderful, wonderful husband and caregiver.
Nancy Chimsky: I wouldn’t be here without his support and love and help because he’s been a champ, my rock.
Linda Giampa: That’s great. So many people on this call will appreciate your story and feel that they’ve been through many of the same things that you have outlined, especially when it comes to the doctors and the various symptoms. And every Lyme patient is different, and we know that. So, I want to mention again, you can begin asking questions through the Q&A at the bottom of your screen and we will get to those at the end. And so from there, I’m going to turn it over to Dr. Schweig and welcome him to the webinar. Thank you.
Sunjya Schweig: Thank you, Linda. Thank you, Bay Area Lyme, for hosting this important speaker series. Thanks so much, Nancy, for your really, really important story and for sharing what you went through. Thank you for your kind words about our work together. I’m glad I was able to help you on your journey. And thanks everyone in the audience for being here tonight and for diving into this important topic. And we all know, many of us know, I’m curious during the Q&A, you can pipe in maybe of just where you are at with your experience.
Many of us know this illness personally and firsthand, and that’s how it started for me. I was finishing my family practice residency at the UCSF Santa Rosa Family Practice Program. And I had just started in a functional medicine practice like Nancy mentioned. It was in Petaluma, California, with my mentor Brian Bouch, MD, who had been a wonderful teacher and trainer for me. And I had the honor of jumping right in with him. And about a year later, my wife was diagnosed with Lyme disease and really became acutely sick.
And it was a very similar story. It was a situation where we went to a variety of different doctors. We didn’t get a clear answer. It was actually because I was working with a colleague of mine in an integrative medicine practice, and I told him what was going on. He said, “That sounds a lot like Lyme disease.” It was like that first practitioner you saw, Nancy, you kind of clued into the story because of this personal experience.
So, fast forward a lot of years. I’ve been doing this work for 15+ years and I am very, very committed to it. I’ve had the honor of being able to serve with the Bay Area Lyme Foundation on their Scientific Advisory Board as well as do some really, really interesting research on botanical medicines for Lyme disease, and I started the California Center for Functional Medicine almost a decade ago, actually in 2014.
And over the years, we’ve really crafted as comprehensive an approach as we can figure out. And what we have figured out is that, as we all know, these are very, very complicated illnesses and they are what we call multi-symptom. You can have almost any symptom in any body part, and almost any body system can be involved. There are issues with persistent infection, there’s issues with inflammation, there’s issues with immune dysregulation, hormones, sleep, nervous system, cardiovascular, you name it, it happens. And so, it requires a really comprehensive lens, a really comprehensive look and a broad mind. You have to be curious. You have to be open-minded. It requires staying on top of the latest developments with testing and treatments and knowing how to use them, the labs and whether it’s antibiotic protocols or herbal protocols or supplements. But it also requires a deep dive on the lifestyle pieces.
And so that’s kind of where we’re going to focus tonight. I think it’s just a really good topic to brush up on with everybody. And I think many of you probably know a lot about this, you’ve been living it, but there are always pearls here for everybody. There are always pearls in places if you’re feeling stuck where you can really double down and do some work on making sure you’re crossing your T’s and dotting your I’s and really focusing, because by focusing on nutrition and sleep and stress and hydration and your blood sugar, your metabolic health, and your metabolic balance, you can do a lot. These bugs like an environment of confusion and inflammation and cytokines and this kind of complex milieu of just a lot of junk and a lot of toxins. That’s how they thrive. That’s part of how they play this game of cat and mouse with the immune system by generating this huge immune response.
DEEP DIVE ON-BOARDING
Sunjya Schweig: Through some of these lifestyle measures, we can really quickly turn around some of these pieces and clear up some of the immune confusion. So, when patients come to see us, we do what’s called our deep dive onboarding, and we have this four-visit series that we ask people to partake in as an intake where we take a comprehensive history, we start getting some labs done, and before we even have the labs back, we immediately have them start to work with our nutritionist and we get a gauge on where their diet is and start them on the 30-day anti-inflammatory reset protocol, which we’ll talk about tonight and get them hydrating, get them removing food triggers, and then they work with our health coach and help get support around sleep and neuroplasticity, brain stress management movement, hydration, all these pieces.
And then when the first round of labs come back, then we regroup and we do what’s called our case review. And so really, even before we get into the weeds with some of the nuts and bolts of the care, we really like everyone to embark on this sort of lifestyle reset with the support that’s needed because we recognize it’s not easy. Many people are struggling cognitively or struggling with energy or struggling financially to make all these purchases of new food and new gadgets, whatever it is. But a lot of this really boils down to some pretty simple changes that with the right guidance and the right support, we really, really, really see make a huge difference. So, I’ll go through some slides and we’re looking forward to an opportunity at the end for Q&A, but let me just do this screen share.
FOOD AS MEDICINE
Sunjya Schweig: The foundation for this work is making sure we know what’s going on with your gut, your gastrointestinal system, and what’s going on with your nutrition intake. And this is really a passion of ours, a favorite thing for us to do, whether you’re a patient, whether you have Lyme disease, if you have autoimmune issues, if you have thyroid problems, if you’re perimenopausal, if you’re a man with low testosterone, if you just want to optimize your longevity, your health span, your lifespan, all the way up to firefighters and first responders who we work with, and we put them through these protocols as well, and they’re just really, really foundational and really important. So, some of the principles of what we’re talking about with this kind of concept of anti-inflammatory nutrition is this idea around nutrient density which is very critical. So we need to be eating the most nutrient dense foods that we can possibly eat, and those tend to be your fruits and your vegetables and your healthy grains and your healthy sources of protein for whatever your personal preference diet is.
Omnivore, diverse omnivore, eating a lot of different things, eating head to tail. If you eat animals, eating a lot of different organ meats, all the different parts of an animal, a healthy animal, meaning like antibiotic-free hormone-free, et cetera. We don’t really love supermarket plastic wrapped generic feedlot meats because those are really not healthy for us. They have a lot of toxins and antibiotics, et cetera. We’ll talk about that. Avoiding foods which are commonly inflammatory or cause inflammation for many people—gluten is a big one. Nancy, you’ve talked about that. Processed foods, sugar, we’ll talk more about that. Eat lots and lots of vegetables, eat as many vegetables as you can get your hands on. And then balancing your fats and macronutrients, et cetera. And this can do a lot for our overall health. This can balance our immune system. It can reduce pain and inflammation.
It can improve your mood, your strength, your sleep. It can improve your brain function, it can help you recover from injuries, it can help you recover from chronic infections. So, really critical. And what we think about in this concept of whole foods, not the store, but the concept is foods that are eaten closest to their natural state, right? Minimally processed stuff, which if you purchase it from the store and you leave it on the counter, it’s going to rot, it’s going to go bad. You have to eat it because it’s fresh and it doesn’t have preservatives in it, et cetera. You want to avoid preservatives, avoid chemicals, sweeteners, artificial colors, antibiotics, hormones, and GMOs. Glyphosate is a huge, huge, huge issue. It’s a pesticide that’s used on a wide variety of different foods, and we’re all being exposed to it every day when we eat conventionally.
And you can’t control all of that, but you can control what you bring home and what you eat at home. And so really, really important hope you have heard about this, the Dirty Dozen and the Clean 15, you can look this up on the environmental working group, ewg.org. Basically these foods listed here are foods which are heavily burdened with pesticides and chemicals in order to grow in a mass, factory farm setting. These are the ones which if you’re going to buy them, you want to buy organic as a rule, otherwise just don’t buy them. And so these foods here tend to be lower in pesticides. So, if you can’t afford to buy everything organic, we personally, spend way more than we probably should. Our budget is largely food-related in our family, so we try to purchase almost everything we can organically.
But if you really have to make a choice, foods over here tend to be a lower pesticide burden, and you can again, look all these up on ewg.org. We really want you to eat the rainbow. So, all of these different colored fruits and vegetables have a purpose. Every color that you see there is a different blend of antioxidants and phytochemicals. And from some of the work we’ve done on botanical medicines and researching this as killing bugs, killing Lyme disease, killing Babesia, killing Bartonella, et cetera, their action is largely through these nutrients, these phytochemicals, they can be anti-inflammatory, they can be anti-cancer, they can be good for your heart, they can be good for your bladder memory brain, but they can also help to lower inflammation. And lowering inflammation can be really helpful for controlling these infections as part of the story, right? Meal composition, you want it to be a nice mix of protein, fat, and healthy carbohydrates, right?
Carbohydrates are also going to be your cookies and your crackers and your cakes and your pasta and your white rice, and you want to lean away from those towards these really healthy carbs. The sweet potatoes and regular potatoes, we tolerate them and root vegetables and beets and some grains are okay. If you tolerate them well, you can prepare them in a particular way like soaking them and slow cooking them. That can be very helpful. Healthy sources of protein, you can see many of those here. Nuts and seeds, fish, chicken, eggs. I like this picture, this egg. So, just look at this yolk and kind of think about what do you see? It’s actually quite dark. It’s orange colored. If you do a little experiment and you purchase some generic eggs at a mainstream supermarket like Safeway that are non-organic and you bring them home and you crack the egg, the shell will be very, very fragile.
It breaks very easily. It just kind of shatters. And the white of the egg is usually liquidy, and then the yolk is like a light pale yellow. Whereas if you buy a pasture-raised egg from a smaller farm, you’re going to see this harder eggshell. It cracks and really has some nice strength to it because of the nutrients in that animal. And then the yolk is going to be a darker color. Again, eat the rainbow. So, this darker color means you’re getting a much richer source of phytonutrients and all of these chemicals, when you eat the rainbow, when you eat these egg yolks, when you eat this healthy salmon, that is literally talking to our genes, that’s genetic information that is talking to our cells and our genes and is giving them much, much better building blocks of just myriad different nutrients and enzymes and chemicals and things that we need to be healthy and strong than you’re going to get when you’re eating generic factory farmed food, right?
And I think a huge part of the chronic illness burden in our society today is autoimmune issues, chronic inflammation, chronic gut issues, chronic infections, Long Covid, hormone issues. I mean, so much of this is related to that. We’re basically putting junk into our bodies and it’s a complete evolutionary mismatch from how we have lived for our entire history up to this point. Basically the last 50 to 70 years when things really shifted, and factory farming took off and it was kind of a race to the bottom in terms of getting stuff onto the shelf. It’s cheap and makes you feel full and tastes really good. We call it hyper palatable, all these processed chips and foods and such and additives, et cetera. But they’re basically super low on nutrient density and super low on the genetic information that our body and our cells need to do well.
So very, very important cause I think of chronic illness, we can reverse that. We can make choices in our lives that reverse that and set us up for healing and recovery and optimal health. Healthy fats: fat is absolutely not the enemy. Fat has been demonized over the last 30 or 40 years when we all went to this sort of low fat movement. Everyone started adding sugar to foods and getting carbs in there and fake fats and stuff, which is again damaging to our bodies. Olive oil is excellent, avocado oil can be great. Pumpkin oil, coconut oil, nuts. I personally love nuts. I think they are great. They can be hard for some people with autoimmune illnesses to tolerate. But if you do tolerate nuts or you’re coming back to try nuts after not eating them for a while, look at the Weston A Price Foundation.
And what I’ll do is I’ll soak them and then dehydrate them. I’ll take a bag of organic almonds, I’ll soak them overnight in a big pot of water that covers the level of the nuts. Put some salt in there as well. Mix it around, leave it there for 12 to 24 hours, drain it, put it on a cookie sheet and put it in the oven at the lowest possible temperature that your oven will go. Mine right now goes about as low as 170 degrees, which is decent, but optimally even like 115 degrees, 120 degrees, even better if you have a dehydrator, and I’ll leave those in there for sometimes up to 48 hours. I always keep testing them every 12 hours or so. And then when they’re done, they basically have these really nice crunch and top to them.
What you’ve done is you soaked it and so you sprouted it. You activated these internal enzymes, you made it more healthy, more digestible, easier on your digestive system, and then you dehydrated it. That’s kind of what you’re thinking about sprouted food. It’s an activated food. It’s a very healthy food, and it’s easier on your body because it’s also already partially digested. Again, healthy carbs, if you tolerate beans and lentils, great, soaking them overnight as well can be very helpful for that sprouting effect. Yams, winter squash, yucca, potatoes, tomatoes, et cetera. Nightshades or nightshade foods—you have to be a little bit careful if they are causing you inflammation. There’s some nuance there. Sometimes people with arthritis or chronic inflammation do well with removing nightshade foods, but if you tolerate them well, there’s no reason not to eat them. Again, healthy organic farmers’- market style.
In our nutrition protocol that we ask people to undertake it for 30 days or so, you don’t have to do it for the full 30 days. If that feels oppressive, you could do it for 10 days, you could do it for two weeks. Whatever it is you feel like you want to do for a reset, basically these green foods, you can eat as much as you want. It’s not a lose weight diet. It’s not like you’re trying to starve yourself. You can basically have all these healthy foods that you want, you want to have in moderation, coffee and caffeine and tea, et cetera. And then basically you just want to get rid of or remove completely 100%. Don’t eat any of them for this reset. All sugar, all sugar-containing foods. You have to read labels very carefully as I’ll show you any gluten-containing grains or if you want to really go extra, just take out all grains and all alcohol.
You do this reset and it’s pretty amazing what happens to people. A lot of times pain, inflammation goes down, brain starts working better, energy gets better, sleep gets better. Weight loss is frequently a beneficial side effect for many. If you’re underweight, you have to be careful of that. You have to make sure you’re getting enough food and enough nutrient density, et cetera. If you would like, I’m happy to provide you with our handout for this. We have a few different resources that we can give you. I’ll send you an email at the end. You can send us a note and we’ll send you some of these reset nutrition guidelines as well as some infographics that summarize each topic that I’m going through tonight. So we have a one pager that kind of goes through each of those so that hopefully that’ll be helpful. So, this is kind of what your plate looks like, right?
Again, half of your plate is your non-starchy vegetables, your greens, cruciferous vegetables, anything in there of the other half. One third of it’s your protein, one third of it’s your healthy fats, and one third is your starchy vegetables, et cetera. So, it gives you an idea.
GUT HEALTH
Sunjya Schweig: Gut health, gastrointestinal health cannot be underestimated when we are talking about how to get you better from chronic illness and how to prevent any future chronic illness. And that’s our passion: how to prevent chronic illness and how to reverse chronic illness. Your gut is where you break down, you absorb all your nutrients. It provides the building blocks for your body, and literally over 70% of your immune system is located in your gut. And there’s trillions of microbes. There are more bugs and viruses and fungi in your gut that belong there, that should be there literally more than all the other cells in your body—probably by a factor of 10 to one.
And if you look at how much genetic information that population contains compared to our own genetic information in every cell in our body, it’s actually probably about a hundred to one. We’re outnumbered, right? So as Justin Sonenberg at Stanford likes to say, it’s kind of like we are just kind of an elaborate transport mechanism for different bugs. And when things are going well, that’s no problem. That’s actually critical for us to live. And it’s obviously when things start to go awry with these chronic infections or microbiome imbalances, that we become sick, and we have increasing issues. This is an interesting fact: 70% of your immune system is located in your gut. Sounds kind of amazing if you haven’t heard that before. But it also just makes sense because if you think about it, from your mouth to your anus is outside of your body, it’s basically an external compartment, right?
It’s contiguous with the outside world and your body then has to decide everything that comes past there: Is this good for me? Does this come into the body? Does this stay out of the body? And we want your guts to be what’s called nice and healthy and have good what are called “tight junctions.” Your cells are really stuck together like this. But if you start to get intestinal permeability or leaky gut, these cells pull apart a little bit and now stuff can be leaking in and exposing your immune system, triggering your immune system, causing immune confusion. And this is all on top of the Lyme or the Babesia or the Bartonella or any other viruses or pathogens, et cetera. The list goes on. So, the information that we’re taking in by our mouth on any one given day, far out numbers the amount of information that any other body compartment has to process, mainly skin and respiratory, the other two immune barriers and the amount of information coming into your gut is much, much bigger.
So, that’s where a lot of your immune system is hanging out, kind of paying attention to that frontline like: Hey, what’s going on? What can we do? What should we do? Et cetera.
SUGAR
Sunjya Schweig: So, I mentioned sugar briefly. Sugar is very, very, very important to pay attention to because of just a really long list of potentially problematic effects that it has on our body from blocking our immune system to increasing inflammation to being potentially carcinogenic. And so really all these things that we want to be running optimally when we’re trying to recover from chronic illness can be negatively affected by sugar. And so, here’s a long list of different effects. Some of the effects that can be attributed to sugar are mineral imbalances, calcium, magnesium absorption, immune system problems, tissue elasticity and function. This is a critical issue for people with Lyme disease and co-infections, right? A lot of people have hypermobility syndromes where they have collagen issues, they have repetitive injuries that don’t get better quickly, the list goes on…
Hormones, cancer, fatty liver, gut issues, et cetera, et cetera, et cetera. So, if you do nothing else after this talk, just try to think about having a period of time where you completely cut out sugar and it doesn’t have to be forever, but what I want you to experience is how you can feel differently when you do that. Hopefully you will feel it, you’ll feel better, and then I really want you to experience what you feel like when you reintroduce it. So, how you suddenly like, whoa, I didn’t realize I was going through those energy swings, or I’m so tired all of a sudden, or my brain’s not working or I’m not sleeping as well, or my moods are off or I’m more inflamed. All these things. And then you have a choice to make. You can decide when you have it, and when do you not have it?
But it just kind of slips by. It’s just one of those things that’s just pervasive in our society and we really need to be more proactive and make conscious decisions around sugar. And 74% of packaged foods have some kind of sugar in there, and there are 61 different names for sugar on food labels. So it can sneak past you, right? This granola bar, for example, it’s got some oats, it’s got some sugar, okay, that’s sugar. It’s got some yellow corn flour. It has honey, that’s another form of sugar. It has brown sugar syrup. That’s another form of sugar. All of a sudden there’s three forms of sugar. Another name is agave. Agave is not necessarily healthier for you than regular sugar. It just sounds cool because it’s a cactus and it makes you want to think like, “Oh, this is a plant, so it’s better,” but it’s not. It’s just sugar, brown, sugar cane, sugar, sugar, dextrose corn syrup, high fructose corn syrup, fructose glucose, honey. I mean, there’s many different names. So, if you’re choosing a packaged food, try to find one that has less than five grams of sugar per serving and pay attention to the added sugars section.
Roughly speaking, there’s about five grams of sugar per teaspoon. So, in this package, there’s two thin slivers of granola bars in there. They try to break it down to one bar of two bars to who’s going to actually just eat one of those thin slivers of granola bar. Most people are going to eat the whole thing. And then you’ve eaten 12 grams of sugar. That’s the equivalent of almost two and a half teaspoons of sugar. If you were going to sit down for a snack, would you serve yourself up two and a half teaspoons of sugar? Probably not, right? If you drink a soda, many of those have 40 grams of sugar or 50 grams of sugar in them. That’s basically like eight to 10 teaspoons of sugar where you just kind of went, would you put that much sugar in your coffee or your tea?
Never! But we just don’t notice it. It just slips by because of these hyper palatable foods, all the sugar out of it, we just get used to it, which is kind of how it tastes, and it numbs your taste buds. You don’t notice it as much anymore.
HYDRATION – WHY WE ALL NEED TO DRINK MORE WATER
Sunjya Schweig: Now the next thing is Hydration. How many of you are getting enough water and how easy or hard is it to get enough water in your life? We want to be drinking enough water so that we’re basically really, really, really well hydrated. Nancy’s drinking, I’ll drink to you. Cheers, basically. One easy way to tell this is that when you go pee, you want your pee to be basically the color of the water in the toilet bowl or maybe a little bit straw colored, but you don’t want to start out when you go pee and there’s a fresh water in the toilet and you get up and you’re done, and there is yellow or dark yellow. If your urine is yellow or darker, you’re not drinking enough water, period.
And when you’re not drinking enough water chronically, you lose your thirst cues, and you don’t get thirsty as much. It is a vicious cycle. So it’s really important for cognitive function and detoxification and body composition and your digestive juices, physical performance, recovery from injuries and illness and chronic illness and flushing out toxins and antibiotics and herbal debris, everything from killing off these bugs, et cetera, for your joints, for your red blood cells, all of these pieces. Basically another rule of thumb is to drink half of your body weight. If you take your weight in pounds but call them ounces instead and divide that in half, you want to drink at least that much water every day. So, if you’re 130lbs, you want to be drinking 65 ounces of water daily. You want to add more water if you are drinking any caffeine or any alcohol or you’re exercising and sweating. Caffeine and alcohol are both diuretics. They’re going to make you pee and lose water and exercise and sweating.
Obviously, you’re losing fluids, et cetera. So, the minimum is half of your body weight in ounces every day, and that’s actually a little tricky to do, right? That’s a decent amount of water. My friend and colleague, Dhru Purohit has a nice podcast on his hydration challenge if you want to look that up. But basically what he says, and so I’ll go out first thing in the morning, I’ll wake up and I’ll drink a big thing of water up to 16 or 20 ounces of water, which is one of these mason jars. I’ll just fill it right up and right after I fill it up, I’ll fill up the tea kettle and put the tea on to boil. And so, I’ll basically chug that much water with some salt, some Himalayan salt in it or some electrolytes, and then when that’s done, I’ll make a big cup of tea. I don’t drink a lot of caffeine personally, that’s up to you. But again, if you’re going to drink caffeine, you want to drink more water, caffeine, fluid doesn’t count as your water, honestly, because it’s dehydrating. So then immediately you’ve made a second one and you’re starting to drink that second one while you start to get on with your day. And so, all of a sudden, first thing in the morning, by 10:00 AM I will have drunk, gosh, 40 plus ounces of water.
So that’s kind of one trick to really making sure you’re off to a head start and you’re going to make this work. So, lots and lots of benefits, good for your body, good for your skin, also helps you feel satiety. So if weight is an issue, if you’re gaining a lot of weight, hydration is one critical element of that stainless steel or glass, please try to avoid plastic if possible. Plastic is a source of toxins and chemicals, and at the very, very least, if you’re using plastic Tupperwares, absolutely never microwave anything in plastic. When you do that, you’re leaching plastic chemicals, really toxic stuff into the food and very much risking or disrupting your internal body processes and systems. I almost never drink anything from plastic with the exception of, for example, when I’m going backpacking and I use one of those, maybe those plastic Nalgene bottles because it’s not going to break and it’s a little bit lighter.
STRESS – AND HOW TO MANAGE IT
Sunjya Schweig: Shifting gears, let’s talk about stress. I hope I’m not stressing you out with this talk first of all, just because it’s a lot and it’s a lot to do and it’s a lot to think about and there’s a lot of layers to this work. I don’t want you to become more stressed because of all these extra to-do items. I think many of you probably know a lot of this already hopefully, but stress and chronic stress is really, really critical. And as we’re talking through all this stuff, just do what you can, right? Little baby steps, totally count. Making these healthy habit changes is not easy. It can be hard. It can be hard sustaining them. The whole New Year’s resolution of: “ I’m going to do this and then go hardcore with it” can be helpful for a short term, but if you overreach and you’ve done more than you’re going to be willing or able to incorporate into a daily habit, then it’s pretty quickly going to lapse.
So, baby steps: do what you can and just keep stacking and keep adding a little bit more at a time.
Stress is basically a threat, whether real or implied, to psychological, or physiological integrity of an individual. And it’s kind of just any event then in which the external demands or the internal demands or both kind of tax or exceed the resources of that individual. And so, we have what’s called eustress versus distress. Eustress is good. Don’t fall into the trap that stress is bad. Stress is not bad. Stress can be very good. Stress can serve to sharpen our minds and to make us wake up and make us get stuff done and be more productive and be more fulfilled and push ourselves physically and cognitively and the list goes on.
But again, if it’s more than short-term, if it’s long-term and chronic and it continues to exceed or tax our resources, then it is potentially damaging. And so, there’s also a lot of really important work talking about the vagus nerve. So the vagus nerve is one of the central cranial nerves that goes back from the brainstem and basically innervates all of these organs in the body that kind of has its hand in everything. It’s called the wanderer. The vagus is Latin for wanderer because of all the different organs and places that it can take a role with. And so, we can work with the vagus nerve, we can try to do exercises to help it to work better. We can do relaxation techniques, neuroplasticity, brain retraining techniques, ways of working with trauma. Trauma is very, very important as a trigger and an antecedent for chronic illness.
We like to differentiate between big T trauma, macro trauma versus little T trauma or microtrauma, and these are all things which stack up over time and can have an effect on our overall body organism and our health and our ability to recover when we are now under these other stresses from chronic infections or chronic inflammation or food sensitivities or not enough sleep or artificial light exposure or something really big.
CHILDHOOD TRAUMA
Sunjya Schweig: There’s also this concept of what are called ACEs, adverse childhood events. There’s a questionnaire online that you can look at called the ACE score. You can get a score and basically this very clear research shows that for those of us who had trauma during childhood, that predisposes us to having chronic illness of a variety of types. And so these are usually big T trauma, although it can also be a little tricky, can be bullying and not being taken care of well by our parents for a variety of different reasons.
From small things up to really big things, substance use, any incarceration, mental illness, any violence, loss of a parent from divorce or death, et cetera. Any abuse. Obviously, those are big T traumas, right? So it’s really important to understand that not only does this happen in your current life, but it also goes all the way back basically from a functional medicine point of view. We care about everything that has ever happened to you from kind of forever. Definitely in the womb it can go back farther than that, even ancestrally. From genomic point of view, it’s called the exposome or from an epigenetic point of view, you can definitely have genes turned on and off, parentally, and ancestrally, but definitely obviously from when you’re in your mom’s belly to when you were born all the way up, everything counts, right? The body keeps the score. If the body doesn’t forget all that stuff that happens in your brain too. Fortunately, you can get in there and you can unwind that, and you can really work with your abilities.
You can work with a therapist. You can do things like EMDR and EFT or tapping. You can do brain retraining techniques like our three favorites are: DNRS, the Gupta method, and Alex Howard. These are basically rewiring the brain, rewiring the nervous system, getting to the point where you can take those old traumas and those current traumas and choose how you respond, and that’s very, very important. Kelly McGonigal has a really wonderful book called The Upside of Stress, and that stress is stress, but stress is really how a lot of it’s important to be nuanced about this. You can differentiate, but a good number of things that we perceive as stressful are really that. It’s how we perceive it, and we can decide, and we can reroute that stress response through some of these brain retraining programs, which really do work time and time again, we hear from our patients, of course, definitely don’t want to belittle any traumas, any active traumas.
I don’t want to tell you that “You just have to get over it.” It’s not that it’s just in your head. It hurts me deeply when patients are told that by doctors or by other people, but there is this factor where you need to come at it from both sides. You need to deal with all of the absolutely real health issues, the infections, the Lyme disease, the co-infections, the inflammation, the gut, all these pieces, but you also need to work on it from a cognitive/brain side, and they both really help.
MEDITATION AND BREATHING
Sunjya Schweig: Okay. Let’s talk about good old-fashioned meditation and mindfulness. Just don’t discount it. It’s so powerful. It’s so helpful, really, really, really helpful. There’s a variety of cool tech opportunities for this. There are apps. My favorite is Buddhify $4 99. Seems expensive for an app. Don’t second guess it. If you want to try it out, just go buy it. It’s amazing. Really cool interface, really cool short meditations up to longer ones. Calm is excellent. Headspace is excellent. There’s a variety of different tech resources, 4-7-8 breath. So, we do a lot of work with breath work and breathing, and you can really access your nervous system. This is an amazing book called Breath by James Nestor. Highly recommended. If you don’t have it, you haven’t read it, but breath is an incredible way to get into our nervous system and to reset our physiology on demand. The military, the Navy Seals, were teaching this to firefighters and police, and because you can get out of your head and get into your body and reset that stress response on demand when you train yourself to do this. 4-7-8 breath is one of my favorites. I originally learned this from Dr. Andrew Weill. Let’s do a couple rounds of it. Let’s get a little Zen feeling going here. Basically, put your tongue up against your top teeth. You’ll feel a little ridge of tissue there, and then breathe all the way out through your mouth.
And then when you’re done with that, breathe in to the count of 4, 1, 2, 3, 4. Hold your breath, 2, 3, 4, 5, 6, 7, and out through your mouth, 2, 3, 4, 5, release, seven, eight. In through your nose, 2, 3, 4, hold, 2, 3, 4, 5, 6, 7 out through your mouth, 2, 3, 4, 5, 6, 7, 8. One more time through your nose, 2, 3, 4, hold and relax your body. 2, 3, 4, 5, 6, 7, and release, 2, 3, 4. Let your body go 5, 6, 7, 8, and just feel your body settled down. That was just three sessions, three rounds. You can do this for four to eight rounds. You could do it for a minute. You could do it for up to five minutes. We have a breathing course, a short breathing course on our website as well under our programs where we give you a bunch of different breathing exercises. This is one of them for different time periods too. I’m happy to also actually provide that for anyone. If you want that for free, just email us as well and we’ll send you a link to that.
So with the breathing piece and the meditation piece, you really want to try to get some practice doing this. You want to try to do it five or 10 minutes twice a day. Again, we like to do things in these 14 to 30 day chunks, and so you sort of do a challenge. You try to get yourself to get into the practice of it and then see the effects of it. This gets a little complicated. I’m going to kind of move through this, but impaired stress response. When your stress response is out of balance and you’re, you’re feeling more stress, more fatigue, you’re peeing more during the night, you’re easy to anger, more sugar cravings, right? Vicious cycle sugar cravings when you’re stressed, but then sugar makes you feel more internal. Stress. It is a stressor on the body. You can feel more light sensitivity, you feel more need for caffeine. You’re not sleeping as well, et cetera.
So very, very important. I think I talked through this just kind of freestyle, but stress and chronic disease is deeply connected and there’s a lot of different health consequences of that. And a really important area is that we can be very purposeful and make some changes and access the benefits of some of these techniques. Okay, so some questions to ask yourself. If you’re feeling like you are, wondering if you’re feeling a little bit of extra chronic stress. Am I anxious, depressed, overwhelmed? Am I getting angry really easily? Am I irritable? Do I need caffeine or sweets or am I sensitive to noise and light? How’s my sleep? Et cetera.
All these factors are critical. Everything links up from a functional medicine point of view. There’s all this crosstalk, right? So, in order to balance your stress response, you need to be sleeping well. You need to be exercising, not having toxins coming in, having an active stress management practice, mindset, gratitude, appreciation, all these pieces, nutrition, et cetera. Okay? Gratitude and appreciation are really not to be underestimated. These are some cool techniques for stress reduction. We talked about a lot of them also: Tai chi, Qigong, yoga, shaking, dancing, laughing. When you’re under stress, you’re going to be breathing more rapidly. You can control that with what we just saw with the 4, 7, 8, and breathe more deeply and more slowly and activate your relaxation, nervous system response.
SLEEP
Sunjya Schweig: Sleep is really, really critical. And I think it is really a major problem across society. I think many of us, if not the majority of us, have some trouble sleeping. I do. I’m not a great sleeper as all those years of being on call and having my sleep disrupted and the stress of going through medical training and I really actually haven’t recovered. I’m pretty restless and move around a lot. I use an Oura Ring as a wearable to track my sleep and help me dial it in and figure out which things are helping, and which things are worsening it. But there’s definitely this cycle, this circadian rhythm that we go through every single day. And it has various different parts of our physiology working with temperature and blood pressure and hormones and brain function, cardiovascular health, et cetera. And so, we can kind of hack this and activate different parts of this cycle for our benefit.
There are a variety of different things that we can do to boost our sleep. So sleep hacks, sleep hygiene, reducing artificial light, getting all technology out of the bedroom, not being on your screen at all in your bedroom or ideally two hours before bed is just hard because the whole dopamine loop of our screens and our texts and our social media, Facebook and Instagram, and it is designed to hack our brains and get us on an app and on device as much as possible, but that puts a lot of artificial light into our faces and that is very disruptive to sleep. And we’ve shown that. I’ve seen that in my own life and my own body, but we’ve shown it with cohorts of patients and firefighters, et cetera. So really, really important noise. Avoiding stimulants like caffeine.
Caffeine has a half-life of about eight hours. So, if you have one cup of coffee in the morning, about one quarter of that cup of coffee is still in your body when you’re going to bed. If you had a cup of coffee, if you had two cups, if you had a cup in the afternoon, you basically have anywhere from a half a cup to a full cup of coffee, caffeine in your body, and no wonder we’re going to have trouble falling asleep or we’re going to have restless sleep or all these problems that we have, right? Morning light exposure is really, really important. This is very underappreciated. So, in my morning routine right after my water and I put the tea on to steep, and then I’ll go out and I’ll walk for 10 or 15 minutes and ideally get bright light onto my eyeballs. No sunglasses, no hat. You basically want the direct light going into your eyeballs so that it activates what’s called the melanopsin receptor, and that helps you clear leftover melatonin, so it wakes you up.
But it also does this amazing thing about telling your body and your brain that this is the start of the day. And so, once your body knows that reliably, it actually has a much easier time falling asleep at night, right? So the important thing for sleep is to get outside. Alcohol is terrible for sleep. It’s just like if you have any wearable, you’ll see this for yourself. It makes you a little more tired. You think it’s helping. It makes you fall asleep. You unwind. It routinely stresses your body, it elevates your resting heart rate, it decreases your heart rate variability, which is your nervous system set point and causes more fractionated sleep.
Brain dumping is really important. So just having a journal by your bed where you can just dump all your busy thoughts into it right before bed, really, really helpful. Journaling. I have a special pen that I bought where it’s a red colored light up tip. So if I want to wake up in the middle of the night and I want to jot down some thoughts that I’m having that would otherwise keep me awake because I want to make sure I remember them in the morning. You can turn on your little light up pen, jot them down, let them go, do the brain dump, and then get back to sleep much more easily.
A variety of different herbs and nutrients can be super helpful for sleep. Just be careful with what other medicines you’re taking, if there’s any interactions or your own personal tolerances. So, lots of problems along with sleep deficiency, really, really hard on your body, on your immune system, on your attention and cognitive function. More accidents, erectile dysfunction for men, worse, metabolic conditions, hypertension, stroke, heart disease, diabetes, weight gain. This is all tied into inflammation, worse immune function, fighting these infections that we’re trying to clear, et cetera, et cetera, et cetera. The risk goes on. So sleep is just kind of unbelievably critical.
So all these things that I’m talking about tonight make sense. We know about them, we try to optimize them, but you really can’t underestimate the importance of these factors on overall health. And for the most part, they’re free. There’s stuff you can do at home, and you can work on yourself, but also get the help you need because health behavior change is hard. That’s one thing that we’ve seen time and time again with our patients. It’s hard to stick to these things. I’m guilty of that too, right? You have the best intentions, but then life gets busy and you get lazy and all of a sudden it’s 11 o’clock and you’ve been doom scrolling on Instagram for you don’t know why, what reason, right?
And so, it takes some habit formation and intention and some support too, whether that’s coaching or community or friends or external accountability partner, et cetera. So breathing, dysfunctional breathing is super critical for sleep.
One other homework item that I want to give you is to find what’s called the stop bang questionnaire. If you know that you have sleep apnea, don’t worry about this because you’ll screen positive for sleep apnea, but if you’ve never been screened for sleep apnea, you’re not sure if you have it, you’re not using CPAP, go find the stop bang questionnaire and fill it out, right? So, do you snore? Are you tired? Has anybody observed you stop breathing? Are you having high blood pressure? What’s your BMI? What’s your age? What’s your neck circumference and what’s your gender? And then you’ll get a score. And if there’s any concern there for sleep apnea, you absolutely should be evaluated for that with a formal sleep study, or we use a variety of different home devices for this.
There’s a sleep image ring, there’s a watch device that will measure a variety of different parameters. So we send these out to our patients at home, but we really, really, really want to know what’s your oxygen level at night? What’s your breathing pattern? Are you snoring? Are you stopping breathing or gasping? What’s your airway?
PROMOTING NASAL BREATHING
Sunjya Schweig: If you’re breathing through your mouth during the day or especially during the night, there is a really impressively and surprisingly long list of negative consequences. From that, we want to always be breathing through our nose. And so, you can actually try different training methods for this nasal breathing breath training. You can actually also do what’s called mouth taping, which sounds weird, but you literally put a piece of tape over your mouth at night and it just forces you or encourages you to breathe through your nose.
And if you’re doing a lot of mouth breathing, this won’t be an immediate adjustment. You’ll kind of feel like you’re underwater, you’re suffocating. It doesn’t feel right. If you can only survive five minutes, that’s fine, take it off. But the next night, do it again and you’ll probably get through 10 minutes and the next night do it again, and eventually you’ll get there. It sounds weird but look it up. There’s a variety of different products that actually allow your lips to open, even like there’s a little slit in the middle and it allows your lips to open if you have to, but if you’re doing any mouth breathing, this could be a game changer for your brain function, for your energy, for your immune function, et cetera.
I mentioned the Oura Ring. We use it a ton personally and with our patients.
And another really amazing book, Why We Sleep, by Matthew Walker. He’s over in Berkeley. Funny story. I was over at North Berkeley by Sauls and the bookshop there walking along, and I saw a Tesla model Y pull up in a license plate, saying N-R-E-M-S-W-S-N-R-E-M-S-W-S. And I was like, what? non-REM, slow wave sleep. I was like, what is that? I was like, could it? And it was Matthew Walker who hops out of his Tesla, and I just totally fanboyed him. I was like, oh my God. I was just excited as if it was like a rockstar. I felt kind of silly, but at the same time it was pretty funny, but really honored to meet him. He’s an incredible guy. Look him up on YouTube. Really sweet, cute English accent. A really great speaker has an incredible wealth of knowledge on sleep, and you’ll be convinced of how important this is. But routinely sleeping less than six or seven hours a night, basically demolishes your immune system. Lots of risk here for chronic infections and also more than doubles your risk of cancer. So, we want to know, we want to know how much you’re sleeping. We want to know what the quality of your sleep is, and we want to know what we can do to improve that.
This is something I do before bed. I saw this on a social post from Kelly McGonigal, the author I mentioned. She basically just puts a sticky note on her lampshade or on her headboard of her bed, and it just says someone, something myself. And the exercise, the gratitude exercise before bed is to think about someone that you’re grateful for that day, something that you’re grateful for that day, and something that you’re grateful for about yourself that day. I try to do this every night. It really helps me just kind of unwind, fall asleep. Again, really, I really believe in intention setting and shifting our brains to better deal with all the things that we’re trying to deal with.
We got through a lot there. I was talking quickly at points. I really appreciate your time and your attention and for being here, and thanks again to the Bay Area Lyme for making this possible.
Linda Giampa: Thank you, Sunjya. Really appreciate it. We have a bunch of questions for you and a couple for Nancy as well. I decided to start with the one that we get all the time, and I think I’ve heard you discuss this before, but it’s kind of a philosophical plus medical question, which is “Is Lyme ever cured, and how do you know?”
Sunjya Schweig: So yes, you can absolutely recover from Lyme disease and go on to live a normal life. Absolutely. If we get into the weeds with that and we try to figure out are those bugs completely eradicated and totally gone? I don’t think we actually know that answer scientifically, but when I gave the microbiome example, at the end of the day, it actually doesn’t really matter because if you are in balance and you’ve done whatever work you need to do from a lifestyle and from a treatment and herbs and antibiotics or whatever it is that gets you to a symptom-free place, you can maintain that absolutely. And your body will then do its work. What I always tell our patients is, we can’t kill our way to health. We can’t just use killers to kill these bugs and expect you to completely recover. We have to get all your other body systems back in action and then your body can actually do that work.
So we have a variety of checkpoints with patients before they graduate, but basically if we pass, if we’ve gotten to a place where they’re feeling really good and they’re not having symptoms and we decide to pause treatment, if we get to the two or three month mark, I’m like, okay, that’s a good checkpoint. That’s cool. If we get to the six-month mark, I’m feeling even better. But if we get to nine or 12 months and they’re still not having any recurrence, then I think they are good for the most part. Now we have to be careful still a lot of people with a history of chronic infections or chronic Lyme, persistent Lyme, persistent tick-borne diseases. If you’re under a new stressor or you get in a car accident or a divorce or somebody dies or there’s a major financial crisis or some of the surgery illness, that can sometimes trigger things or reactivate the symptoms. But yeah, you can definitely recover completely from tick-borne disease.
Linda Giampa: And anecdotally, we do know when we have a lot of people in common who have recovered from Lyme disease and they’re living a good life. So, I hope everyone out there understands that. Nancy, this question is for you and that is, “Have you ever tried brain retraining programs, and if so, have any of those worked for you?”
Nancy Chimsky: Yes, I’ve done some tapping. I’ve done EMDR. Those are the two that come to mind soonest. Yes, they seem to help to some degree. I think at the time the EMDR was really interesting to me, but it wasn’t as easily available in, this was like maybe 2012. You have to be very consistent. You have to stay with it. It’s not something that you can do for six weeks. It was the Arizona place that I tried it, and that was where I did a lot of the meditative and pain management program, tapping. I just didn’t get it. It just didn’t seem to, and maybe I didn’t give it enough try, but it didn’t feel as natural for me to go with that and to stick with it. I feel I get more relaxation techniques and de-stressing from apps like Calm, and I really want to try now that you’ve mentioned.
Sunjya Schweig: That’s awesome.
Nancy Chimsky: Those that are more suggestive work well for me because the whole getting into a place of relaxing and just letting go and absorbing some of the relaxation techniques in apps like Calm have really been helpful.
Sunjya Schweig: And like Nancy said, there’s no one size fits all. Feel free to try different techniques, and if you just don’t resonate with it or it feels too hokey or you’re not getting effects, then just drop it and move on to something else. And there’s so many opportunities out there, just follow your own natural instinct and your intuition and your rhythm. And the DNRS when SCR has been mentioned is really helpful, but it is also pretty restrictive and pretty rule bound. And so, some people struggle with, they’re supposed to do exactly this, and you’re supposed to do it for exactly an hour every single day. And so, there’s some downside to that one. But if people are curious, the Gupta Method, Alex Howard has some really nice free videos on his website. You can get a flavor of it, but yeah, try something. They’re really helpful.
Linda Giampa: Okay, I think this is an easy one for Sunjya: “What are your thoughts on Stevia?”
Sunjya Schweig: Some interesting research. Eva Sapi looked at that with possible activity against Lyme disease. I think it’s part of the story. I haven’t seen it to be the game changer for patients, but it’s relatively harmless and there are some interesting studies showing potential activity for it. And so, I do have other practitioners who are using it, and I know that the Cowden Protocol uses it a bunch. So, it’s a possibility.
Linda Giampa: Have you handled patients with FUT(2) genetic variation, and if so, how do you handle this?
Sunjya Schweig: It’s the fucosyltransferase two. I’m just actually looking at it. It is not something I deal with a ton, but it is interesting if the person wants to clarify what they’ve seen about that or specifically what they’re asking. Is this like a treatment avenue?
Linda Giampa: He’s asking about supplements. Are there supplements or treatments? Have you handled it? Okay. I had an interesting one towards the end, which was from a nurse, which is, “Are you diluting your stomach acid with that much water, especially during the morning, and how does that work?”
Sunjya Schweig: Yeah, so that’s a good thought. That’s sort of in the general medicine field, but also Ayurvedic medicine talks about not drinking a lot of fluids with your meals, and especially not drinking cold fluids because that shifts the temperature of your stomach acids and your gut secretions, and that can affect digestion and digestive fortitude. So, one thing for me that I do is I frequently delay my breakfast till about 10:30. So that’s called intermittent fasting or so basically where you’re kind of compressing the time window when you eat down to about an eight hour window. So I’ll usually have breakfast around 10 or 10:30, and then I’ll finish my dinner around six or 6:30. And then you’re basically entering a fasting state after about 12 hours of fasting, you enter, you start to burn ketones for fuel instead of glucose, and that can be really helpful from an anti-inflammatory point of view and from an immune function point of view and the whole mTOR side to it. So really interesting thoughts along that for chronic infections and longevity, et cetera. So for me, it’s not an issue. I can drink all that water and I can absorb it, and I haven’t really messed with my food. But yes, if you’re going to be eating breakfast close to them, if it was me personally, I probably wouldn’t have all the water right then. So maybe have your water, little mid-morning kind of thing.
Linda Giampa: There have been three or four questions on the vagus nerve and people seem to want to know are there exercises for that?
Sunjya Schweig: So again, virtual hands raised, how many people sing in the shower, singing, humming, chanting? I think this is one of the big reasons that so many different world mystical religious traditions incorporate singing and chanting that activates your vagus nerve and you into a parasympathetic or relaxation nervous system response when you also have feelings of blissfulness and heightened awareness, et cetera. So, singing, chanting, gargling, there’s also another really great book called The Healing Power of the Vagus Nerve by Stanley Rosenberg, and there’s a variety of different movement exercises like a cat/cow exercise on the floor and what he calls a salamander. There’s a bunch of different things you can do. Actually, this is a tuning fork. It’s starting to get a little hokey maybe, but really interesting sound energy through this thing.
It’s a 1-28 if you’re looking for these. And these will vibrate bone. This is what a lot of EMTs and emergency technicians do—they have these in ambulances and orthopedic offices too—because it’ll vibrate the bone. They can check if there’s a fracture. But it can activate the vibration similar to how singing or chanting can activate your vagus nerve, so I will ring it and then put it on my sternum or a clavicle or a bone to get the vibration. So, from there, there’s a bunch of different other sorts of devices. I just have these on my desk. This is another one. Apollo Neuro is also a vibration device you can put on your wrist or your ankle, and there are different settings. There’s an app and you can do a wake up or a relaxation or cognitive meditation, again, through vibration and through your nervous system that way. So, a variety of different ways. Breathing, just breathing, all these things activate the vagus nerve.
Linda Giampa: We have questions on probiotics and Lyme patients not being able to get their gut to accept probiotics and what can they do to help?
Sunjya Schweig: So, I think we need a little bit of a bigger lens than can Lyme patients tolerate or not tolerate probiotics, an N of one? And if you can’t tolerate probiotics, it doesn’t mean that you have Lyme disease. There’s many of our patients who have very, very sensitive guts, very imbalanced guts. They have SIBO, (small intestinal bacterial overgrowth), or they have SIF like Frank SIFO (small intestinal fungal overgrowth), or they have giardia or they have other parasites or there’s a whole list of things that we go through. And that’s why our gut reset is the first thing. We want to clear as much of that as we can and get the gut talking to the rest of the body properly. But there’s also tons of different kinds of probiotics. There are your Lactobacillus types, Lactobacillus acidophilus. There’s a bunch of different strains of Lactobacillus with various research to back up the benefits.
There’s your Saccharomyces, like your Florastor, your Floramyces (dairy free). These are beneficial yeast which are helpful for protecting against antibiotic associated diarrhea. There are soil-based organisms, probiotics, in addition to the probiotic, there are prebiotics, and these are health beneficial fibers and either soluble or insoluble fibers that feed the bacteria. So, they are like the fertilizer for that lawn that you’re putting in with the new probiotics. But basically, if you’re having trouble tolerating probiotics, it means that either it’s the wrong one or it’s too big of a dose or there’s something else going on with your gut that you need to figure out.
Linda Giampa: We heard back about FUT(2), in which people significantly lower bacterial gut diversity, which is similar to what we were just discussing and how to maintain your microbiome under those circumstances.
Sunjya Schweig: Yeah, no, it’s good, I’m going to read about it some more. There’s a nice article I just pulled up actually. It’s called A Low FUT(2) Diet for a High Fat World Connecting Intestinal Fucosylation with Western Diet Driven Liver Disease. So, there’s definitely a big discussion out there. It’s not something I’ve dived, delved deeply into. So, this is my favorite part of doing this work and working with our patients is I always get to learn and hear about new things. So, thank you, whoever that was, and I’ll be looking into some more.
Linda Giampa: Any thoughts on kimchi?
Sunjya Schweig: Kimchi is awesome. Kimchi is a fermented food, and naturally fermented foods are wonderful sauerkraut, kimchi, natto, and a variety of different benefits, too many to cite. Some people don’t tolerate it well. They have to either eat very small amounts or avoid it. A lot of times those are the people with SIBO or difficulty tolerating FODMAP foods from a gut point of view. So, just as with anything it’s an N of one, it’s your personal reaction to this, and if it works, great. One weird, strange, but kind of cool thing that kimchi is good for – about 14 days after it’s been manufactured, it has a naturally occurring form of lactobacillus called lactobacillus saki eye, S-A-K-E-I-I. And it’s part of what they use in fermenting saki, but this form of Lactobacillus sakeii is actually really helpful for the rhinosinal microbiome.
So, think someone who has chronic sinus infections, chronic congestion, recurrent sinus infections, needing antibiotics, et cetera. Weird. You didn’t hear it here, or you did, but it’s weird. You can literally take some of the kimchi juice, pour it into a little bowl and put a little bit of it into the outside of your nose, either using a Q-tip or you can use your finger if you washed your hands well and not far up, you’re just putting on the outer part of the nostril. And then the Lactobacillus sakeii can move up into your rhinosinal microbiome and help with chronic sinus infections. If you want to read more about that, there’s a website called lactobacto.com.
Linda Giampa: Wow. Thank you. I will tell my husband right away; he suffers from this!
Sunjya Schweig: If you don’t want to do the kimchi, you can buy lactobacillus sakeii powder and do nasal rinses with your Neti pot or your NeilMed. So up to you. But it’s kind of a funny story about kimchi.
Linda Giampa: There was a question about coconut oil. This person said that there’s lots of literature that says that coconut oil is bad and wants you to comment on that.
Sunjya Schweig: Yeah, so it is definitely an important discussion around what types of fats and saturated fat versus monounsaturated, polyunsaturated fats et cetera. I think that coconut oil can be a healthy part of our diet. It is a saturated fat, but not all saturated fats are bad for us. But it is also individualized, and it depends on your personal history. It depends a bit on your genetics. Side story about the Apo E genetics, which are most commonly known for Alzheimer’s. If you have a 4/4 or a 3/4 of the Apo E, then you are potentially more of a hyper absorber of cholesterol from saturated fat. And so then we want to try to do more of a Mediterranean type diet. But if you have an Apo E 3/3 or 2/3, which are more common, probably not the saturated fat story is probably not a big story contributing to risk of heart disease or cardiovascular disease, et cetera. So, coconut oil is actually a very healthy fat and for a lot of people it’s one of the best fats for high heat cooking. It has a high smoke point. And so, if you’re doing any kind of high heat cooking, it’s one of the go-to oils for us. But again, it’s very individualized.
Linda Giampa: This is something that we all over the last 10 years have seen a lot of: One of the friends watching tonight was diagnosed with Lyme disease two months ago, was put on a short round of antibiotics. The symptoms went away. And then two weeks later they came back with a vengeance and were prescribed doxycycline. It does not say how many weeks or days the doxycycline was prescribed, but they want to know what to do and what the next step is. And we see this all the time.
Sunjya Schweig: We see it all the time.
Linda Giampa: Yes.
Sunjya Schweig: Yes. So, what’s going through my brain is I wonder who you’re seeing, who you’re working with. I wonder, is it a primary doc? Is it an internal medicine doctor? Is it an infectious disease doctor? I wonder about where you’re at with your journey with Lyme disease and how much you’ve dived into how complicated this story is and how there is the mainstream medical view that Lyme is not that easy to get and actually pretty easy to treat. And really you just need your two or three weeks of antibiotics and either you’re fixed and you’re better, or if you still have stuff going on, then it’s not Lyme disease. We actually treated that already. And so, it’s something else. It’s like some post Lyme syndrome or inflammation or autoimmune, et cetera. I’ll go out on a limb. I don’t believe that. That’s not true.
These bugs are really smart. They’re very persistent. If you’ve seen some of my other talks, I show a tree of life showing that here we are at the outer leaves and branches of this tree, and the origins of the spirochete bacteria are at the base of the tree four plus billion years ago. So, they know our bodies super well and they can persist. And Monica Embers, an amazing researcher out of Tulane, published a bunch of studies on this in monkey models. I don’t know what your testing was, et cetera, whatever it was, it sounds like the antibiotics helped. It sounds like they were doing something. And it’s not surprising to me that you had a recurrence of symptoms when those antibiotics were stopped because it sounds like you weren’t treated for long enough. And you also need to be thinking about not just Lyme disease, which is the Borrelia burgdorferi bacteria, but also co-infections.
Is there Babesia? Is there Ehrlichia? Is there Bartonella? Are there other viruses? All these pieces which are not necessarily going to be treated by one antibiotic or by doxycycline. And so, as you dive into this, I’m sorry you’re here dealing with it, it’s a hard, scary place to be. But if you get the right help and you get the right treatment, I do believe you can recover and not have the recurrence, but also just be careful, it puts you in a bind because you’re being told this story by your doctor who you trust, and they’re probably good people. They are probably thinking about this more conservative viewpoint of it all. So, you have to broaden your view a little bit and find someone who can deal with more of the complexity and the nuance. And Bay Area Lyme does have a nice list of supportive practitioners, so I hope you get better.
Linda Giampa: Okay, great. So, the last couple of questions are about your practice and what type of tests do you perform? How do you diagnose? Do you use iGeneX and do you conduct any gene testing in your practice? So those are the last questions.
Sunjya Schweig: Great. We take a very broad view. We do a lot of testing. We will test people with LabCorp and Quest for a bunch of different metabolic vitamin nutrient markers, full thyroid panels with all the different hormones and antibodies will test hormones. The list goes on. We see that as the foundation layer of trying to optimize or balance all these systems. We will test the stool with usually one or two different labs. We’ll test SIBO with the breath test. We’ll test urine for hormones and adrenals. And so a long list of those things. And that’s before we’ve gotten to the bugs. What do we do for the bugs? Depending on people’s insurance status, sometimes we will just run a bunch of tests through LabCorp and Quest if that’s covered. Because a lot of times what we think is if something comes back positive, it means there’s a problem.
But if it’s totally negative, you can’t really trust those tests. So, a yes is a yes on a test and a no is a maybe for any test results. So don’t trust what’s printed on that PDF or that page. If the test says you don’t have it, but you’re having all these wonky symptoms or get a tick bite et cetera, et cetera, you absolutely could have one of these infections. And so that’s a little bit of a hurdle for us to get over, very binary. But then from there, tests on LabCorp Quest, let’s say are negative, and we will definitely test with iGeneX. It’s a lab we use a lot. We will also use Galaxy Labs. They’re I think one of the best ELISA tests. They also have a Lyme urine antigen test, which has been really helpful. It’s a pee test looking for the antigen, which is cool because that’s what we call a direct test, meaning you’re looking at the actual traces of the bug there as opposed to just traces of the immune system.
We will test, we’re using Dr Mozayeini’s T lab tests, which is a RNA probe for Bartonella. So again, a direct detection test. We use InfectoLabs for TSpot testing, and also Armin labs were not available in the US for a couple of years, but now it’s back again. So yeah, we’ll basically test people up, down and sideways trying to find these bugs and also go by their history. We use the Burrascano screening questionnaire, we use the Horowitz HMQ questionnaire, which he’s published on. That gives us a sort of, probably not, maybe, probably yes score for people. It’s basically like pattern recognition combined with testing. And then the other thing that’s a test is trying treatments. So we’ll try some herbs, maybe we’ll even try some antibiotics. And if you respond well to that, or maybe you have a Herx reaction, maybe it flares you. Those are also clues as to whether this thing is there or not. It’s very nuanced and very end of one. But yes, we do a bunch of testing.
Linda Giampa: So, I think that’s it. I think we went through the questions, and I want to thank both Nancy and Sunjya and our team for this wonderful event. Nancy, would you like anything else to say?
Nancy Chimsky: Oh, I just feel I’ve been reminded of a wealth of information and also learned a lot of new things. It was a great, great webinar and I hope everybody was able to gain some knowledge and some hope and that you’ve come to some recognition of things that you need to do for yourselves.
Linda Giampa: Thank you, Nancy. We really appreciate it and hopefully we’ll see you very soon. And Sunjya, any final thoughts? We really appreciate everything that you do for Bay Area Lyme Foundation.
Sunjya Schweig: Yes, likewise. I appreciate you guys too. Thanks for the opportunity. I know I went through a lot of information. I hope it wasn’t overwhelming, but again, if you want the Nutrition Reset handout or if you want any of our infographics, we also have an eBook on botanical medicines. You can just email our practice. So just operations@ccfm.com, or you can go to our website, ccfmed.com and fill out the contact form. We’re happy to send you any of that info. Also, I mentioned the free access to the breathing course. If you want that, let us know. We’ll give that out to you.
Linda Giampa: All right, thanks everyone. Good night!
This blog is part of our BAL Spotlights Series. It is based on a transcript from our Distinguished Speaker Series webinar held on October 4, 2023. To listen or watch the original conversation, please click here. Bay Area Lyme Foundation provides reliable, fact-based information so that prevention and the importance of early treatment are common knowledge. For more information about Bay Area Lyme, including our research and prevention programs, go to www.bayarealyme.org.