Recently I interviewed Dr. Darin Ingels, and we chatted about allergies, asthma, and Lyme disease. If you would prefer to listen the interview you can access it by Clicking Here [1].
I’m very excited to chat with today’s guest, Dr. Darin Ingels. We are going to be talking about asthma, allergies, and Lyme Disease. Let me dive into Dr. Darin’s bio.
Dr. Darin Ingels is a licensed naturopathic doctor, author, international speaker, and leading authority on Lyme Disease. He is a former Lyme patient who overcame his own three-year battle after having failed conventional treatment and became progressively debilitated. Dr. Ingels found that proper diet, lifestyle management, and natural therapies worked with his body to heal instead of against it. He then applied what he learned about his own healing journey to his own Lyme patients and found they recovered faster and with fewer side effects. Dr. Ingels has treated more than 8,000 Lyme patients using his novel approach, many of whom have gone on to live healthy, symptom-free lives.
Dr. Ingels has been featured on WebMD, MindBodyGreen, Be Well, Thrive Global, Motherly, and Dr. Ron Hoffman’s Intelligent Medicine podcast. He is the author of The Lyme Solution: A Five-Part Plan to Fight the Inflammatory Autoimmune Response and Beat Lyme Disease, which I read while I was dealing with Lyme personally. Excellent book. Highly recommend. Thanks, Dr. Darin. Appreciate you joining us here.
Dr. Darin Ingels:
Pleasure to be here, Eric. Appreciate it.
Dr. Eric:
Let’s dive into your background. You dealt with Lyme, and that motivated you to write your book and led you to helping over 8,000 people with Lyme Disease. Can you get a little bit deeper as to how you developed the practice you have today?
Dr. Darin:
Sure. I am a naturopathic doctor by training. When I came out of medical school, I was really interested in environmental medicine, so I studied with the American Academy of Environmental Medicine. That is dealing with all these things in your world that get you sick and keep you sick. It deals a lot with allergies, asthma, and eczema. We also look at pollution, chemicals, mercury, heavy metal toxicity, and other things. That was really a big chunk of my practice.
In 2002, literally two weeks before I was set to open my own practice, I got Lyme Disease. I had classic Lyme. I am one of the few people I have ever seen that had all the textbook symptoms you get with Lyme. I had the bull’s eye rash, 105 fever, headache, joint pain, neuropathy, the whole gamut. I knew I had Lyme. I saw the rash. I got treated with Doxycycline right away. Within four days, all my symptoms completely went away. I felt fine.
If anyone has ever opened their own business, they know what it’s like, so I couldn’t afford staff. I was doing everything myself: scheduling patients, seeing patients, managing the books. I was working six/seven days a week, 10-12-14 hours a day. I got eight months into that schedule, and I started to relapse, having symptoms again. I recognize that this happens with Lyme. I took Doxycycline again for a month, and it did not work. I switched to Azithromycin for another month, and it did nothing. I started working with a local Lyme doctor I knew, and I started different oral antibiotic regimens and got worse and worse. This went on for eight or nine months.
I lost 30 pounds. My gut was a mess. I felt terrible. I had learned of a doctor in New York City named Dr. Zhang. He is a Chinese medical doctor and works as an acupuncturist and Chinese herbalist. I went to see him, and he gave me an acupuncture treatment and started me on a regimen of Chinese herbs. It was just a wake-up call that you’re not really taking care of yourself, dummy. You have to sleep more and eat better, all the things I tell my patients all the time.
Once I took stock of that and started on this regimen, within a month, I felt 80-85% better. From there, I took another two years to feel like I completely got my life back. I got to a point where I was 100% symptom-free.
I started applying what I did to myself to my patients, and I found that people got better faster. It’s looking at the whole person, not just the infection itself. Your diet, lifestyle, stress, all of these things, really play a huge role in your ability to get well. It’s not just about taking a bunch of pills. That then led me to see lots and lots of Lyme patients over the years.
So many people who deal with Lyme at some point end up having some element of allergy or hypersensitivity. We know the persistent infection has this capacity to offset your immune system in a way that it can make you more sensitive to your world. I see people that never had an allergy or sensitivity in their life, but after they get Lyme or some other chronic infection, now they don’t tolerate certain foods or can’t be in a moldy environment, or pollen bothers them, or they can’t pet their dog anymore. There is something in this underlying infection that is upsetting the balance in your immune system that can dispose towards allergies, asthma, or any type of mast cell activation problems.
I took what I learned as an environmental medicine doctor and kept doing it through my practice, even with Lyme patients, because it’s still applicable. Of course, your environment plays a role in everything. Whether you have heart disease, diabetes, obesity, there is often this element of immune dysfunction. A big part of my practice today is still dealing with all these underlying immune issues. We do a lot of immunotherapy in our practice to help modulate the way the immune system responds to these different allergens. We will talk about that later.
Dr. Eric:
Definitely. You mentioned the classic bull’s eye rash. With me, it was the opposite. I had no evidence of a tick bite, no bull’s eye rash. I wasn’t having migrating muscle and joint pain; it was more neurological symptoms. When I went to a primary care doctor, he didn’t want to do a Lyme test. The only reason I suspected Lyme was my experience with other patients who had Lyme. It was neurological symptoms, but everything was moving around. It wasn’t consistent. I went to see a Lyme literate doctor, and sure enough, it was chronic Lyme.
Interesting that you mentioned the connection between Lyme and other infections and allergies. Before we dive deeper into allergies, can you give a brief definition of what an allergy is?
Dr. Darin:
An allergy is an overreaction of your immune system to something that’s part of your world. To this day, we still don’t fully understand what makes people sensitive to cat dander or certain foods. Why is it in the United States, do we have this ridiculous rate of peanut allergy, where in Thailand, where peanut oil is used in everything, and their incidence is extraordinarily low? It’s a complicated issue, and we don’t understand what sensitizes people.
The bottom line is that your immune system is reacting to these things that are in your everyday life. Overreaction creates this collection of symptoms that can range anywhere from pollen allergy, which is typical hay fever, itchy eyes, itchy ears, runny nose, scratchy throat, head pressure, cough.
To things like mold allergy, which can be thick mucus in the back of your throat, chest pressure, headaches, insomnia. Mold for a lot of people can create psychiatric symptoms. Some get horribly depressed.
Some people get skin reactions. Eczema is a classic allergy reaction. Other types of skin rashes, too.
A lot of stomach and bowel problems. Chronic abdominal pain, constipation, diarrhea, gas, bloating.
Joint pain, muscle pain.
Mast cells in particular are scattered all throughout your body, and these kinds of cells can trigger various allergic reactions.
It’s interesting. In the United States, allergy has a very strict definition, and it refers specifically to IGE reactions, or immunoglobulin E. For people to have a classic allergy, pollen or hay fever, people get anaphylactic reactions to certain foods, where your face swells, you can’t breathe, or you get hives. All of that is classic allergy mediated by IGE.
If you read European journals on allergy, their definition is much broader. Some allergy is IGE; some might be IGG. Some might be T cell mediated. There is a lot of immune mechanisms that can create allergic symptoms.
If you go see an allergist, they have a very strict definition of allergy. They will scratch test you. They will do blood testing, looking at that IGE reaction. If that comes back negative, they will say you don’t have allergy. I think it’s a view of what allergy really is. The fact that it’s multi-systemic, can affect any body part, it’s important to understand. If you have these chronic ongoing issues, and your doctor can’t figure out why, I would be very suspicious that there is some element of allergy that may be causing it.
Dr. Eric:
One of the questions I was going to ask you is what do you think about the different types of allergy testing with regard to IGE? You mentioned the skin prick testing and blood testing. It sounded like you might not be a big fan of those. If they are negative, they don’t necessarily rule out allergies. Would that be correct?
Dr. Darin:
They have their place. It looks for a type of allergic reaction. If someone comes in, and they have had a true anaphylactic reaction and are not quite sure what it is, we can do skin prick testing or blood testing, looking at this IGE reaction to help identify if it was peanuts or something else. For those kinds of reactions, they are helpful.
For the reactions like mold, mold is notorious for not being IGE mediated. I have seen numerous people over the years where they go to an allergist, get skin prick or blood testing for molds, and it comes back negative. But every time it rains, or it’s humid, or they walk into a damp basement, they feel the symptoms. You are telling me clinically that mold is bothering you because it’s those moldy environments that precipitates your symptoms.
Often, we are doing different types of testing to look at the broad scope. Sometimes we do blood testing for IGG antibodies. I had one girl in my practice who had terrible hives. We did different IGE tests, and nothing came back. Mom was suspicious, “I know every time she eats oatmeal, she gets hives.” We did an IGG test, and the IGG was sky high. She pulled oatmeal out of her diet, and the hives completely went away. Her IGG level dropped down. That’s an example there are other immune mechanisms.
A lot of these probably involve T cells. Unfortunately, we don’t have great testing for T cell mediated reactions. If anyone is old enough to remember when you used to get a TB test, they would poke you in the arm. You would come back two days later to read it because it’s a delayed reaction. That was a T cell reaction. Because those are delayed, it could be hours to days after the exposure for the immune system to react.
With food reactions, this is an area that gets grossly overlooked. You go to the allergist, they test you for food allergies, and everything comes back looking normal. “You don’t have food allergies.” Their definition, that might be true. You don’t have a food “allergy.” That doesn’t mean you don’t have food sensitivity or intolerance. Both of those can create symptoms.
Then we have to look at other types of testing. Some people do IGG blood testing. Some people do skin patch testing. Some people do more esoteric testing, like muscle testing. There are a lot of different ways you can try and help glean that information about what you’re reacting to. Again, I think when you are talking about testing, at least in our world, often we are doing more than one type of testing because we want to understand the broad scope of what kind of immune reactions are happening.
Dr. Eric:
Do you tend to lean toward IGG testing for delayed reactions for more food sensitivities? There is also ALCAT. There is Mediator Release Testing. Did you have a preference?
Dr. Darin:
We actually do our own in-house testing. We do skin testing for some people. We use types of esoteric testing. We still do some IGE testing. I don’t use ALCAT or MRT or IGG testing. The problems with food, with IGG testing, it tends to show what you’re eating and not necessarily what bothers you.
I did this early in my career. We would do the blood test, get a list of all these IGG antibodies. What was weird to me is that sometimes it would come back with IGG high to lettuce, high to cucumber. This is water and cellulose. If you are reacting to this, you would react to every plant you eat. These are foods that are not generally known to be allergenic. Clinically, I really never saw people react to these kinds of foods. People would tell me, “I have salad three times a day.” Is it just showing what you’re eating and not necessarily what bothers you?
We would change people’s diets based on those results and repeat the test. All the foods they eliminated, the antibodies would go down or away. Now they have incorporated new foods, and we are seeing antibodies to the new foods. I would do this a third time and see it change again. It became very clear that it seemed to be showing what you’re eating and not necessarily what bothers you.
I think the benefit of IGG testing for food sensitivities probably not so much showing what you’re reacting to, but if you have a lot of IGG reactions, it’s a pretty good indicator you probably have leaky gut. If you are trying to help understand if you have leaky gut, because we don’t have great tests for that, if someone has all these high antibodies, the more antibodies you have. If it is reflecting what you’re eating, the fact that all these food substances are getting through the gut to stimulate at least an IGG reaction is pretty telling that the gut may not be as tight as we want it to be. For me, that is the benefit of IGG testing.
A food elimination diet is the gold standard for food sensitivities or intolerances. You eat a very limited diet, pull out all the common food allergies, remove all the dyes and artificial stuff for three weeks. You slowly reintroduce the foods one at a time and see how you clinically feel. That has been the gold standard for food intolerance for years. It’s a very inexpensive, easy way to determine which foods might bother people.
Dr. Eric:
I agree. I have been recommending elimination diets for years for patients. With IGG testing, I know there are a lot of practitioners who use them, and they get good results. The reproducibility of the test is a question. Different labs are different. Some arguably are better than others. I also have looked into MRT and found that interesting.
I agree, the elimination diet- I don’t know if you’d use the word “easy” because it’s less expensive, but some people find it difficult. They could get the blood test and find out what they are sensitive to. But that’s not that easy. You also have to be eating the food when it comes to IGG food sensitivity testing. If you are not eating the food, then you are not forming the antibodies. There are a lot of flaws in my opinion.
Dr. Darin:
When I say “easy,” I mean not complicated. It can be very difficult. When I was a med student, my nutrition teacher was Dr. Alan Gaby, who literally wrote the textbook on nutritional medicine. He had people go on lamb, rice, and pear for three weeks. It sucks. It’s so boring. People don’t like it at all. These are all foods that are considered to be very hypoallergenic. If you wanted to eliminate any other food that might possibly react to you. Then we would slowly reintroduce foods. People had a hard time doing that.
I don’t do that anymore when I do elimination diet. We incorporate more foods than that. You have to pull out all the common allergens and remove all the dyes and artificial sweeteners.
I say it’s easy in that it isn’t terribly complicated. It does take an element of discipline to do this for three weeks. It is inexpensive, and anyone can do it. In lieu of having other tests that may not be as reliable.
When I was a med student, we did one of the labs that does IGG testing—I won’t name them—we took the same blood sample and split it in four samples. We put different names on it and sent it to the lab, and we got four completely different results. I do wonder at least with some of the labs what their reproducibility is. This is now 25 years ago. Testing has gotten better probably. I know practitioners who do IGG testing and say they get great results.
What I find interesting is that people tend to crave the food they are sensitive to. It’s a weird dynamic. It’s almost like a drug addiction. Your brain and body want that thing. If you are eating a lot of the food you’re sensitive to, and it comes up on IGG and you pull it out, of course you are going to feel better. To some degree, it probably is picking some of that up. People do tend to eat these foods a lot. Elimination diet is still the gold standard.
Dr. Eric:
How does asthma relate to IGE allergies?
Dr. Darin:
Asthma can be triggered by a lot of things. Asthma for a lot of people is really allergy of the lung. You come in contact with some allergic substance because asthma is a combination of inflammation in the lungs and constriction of the bronchials. If you look at that inflammatory part, it can be triggered by dust, mold, pollen. There are other non-allergic triggers. Some people get cold-induced asthma or exercise-induced asthma. That can be different.
My experience in people with asthma is the overwhelming majority of them, if not close to all of them, have some element of allergy. When you reduce the allergic load, their asthma improves. It’s still a function of looking at all these different factors that might trigger asthma. We will go through and test them for pollen and dust and mold and common environmental triggers. We will probably look at food sensitivities.
It’s about total load. We are all born with a barrel, and some people have a huge one, and some people have a shot glass. When it overflows is when you become symptomatic. As much as we control each aspect of these things that are setting off your immune system, we get better control of allergies and asthma.
When I used to live in Connecticut, the dead of winter, it’s cold. We don’t have a lot of outdoor allergens. Pollen isn’t pollinating; it’s so cold. Mold isn’t sporulating. We would deal with people’s food sensitivities in the winter. When spring rolled around and the pollen hit, their pollen allergy wasn’t that bad this year. We never did anything for their pollen allergy. Just by reducing the load of the food sensitivities, their immune tolerance to other things got better. It’s always a function of trying to identify what these triggers are, and as much as we can get control over each aspect of it, your tolerance to the rest of the world gets better.
Dr. Eric:
If someone has multiple food allergies, essentially by cleaning up their diet and avoiding food allergies, that could help with asthma?
Dr. Darin:
Absolutely. I have a lot of people that a big trigger for their asthma is something they are eating. Because a lot of these food reactions are not true food allergies, they don’t happen in seconds or minutes. We know from the research that some of these reactions happen three days after you have ingested the food. If there is a day where you feel tight in the chest, short of breath, write down everything you have eaten over three days. I don’t think any of us would be able to figure that out. It’s important to do that evaluation and try and find out what those triggers are.
I have a lot of people with asthma where food is at least part of it. May not be all of it, but again, it is a function of load. It’s important to look at the whole gamut of things that might be setting you off.
Dr. Eric:
What are some of the more natural treatment options for allergies and asthma? My dad had asthma. I remember growing up, he would always rely on his inhaler if his condition got real bad. A few times, he got cortisone shots. This was before I became a chiropractor and knew what I know now. We were brought up eating fast food and junk food. I am sure diet played a role. I know stress in his case, too. I dealt with allergies, too, years ago, and I got the allergy shots. What are some alternatives? I know you do the low dose immunotherapy, which we’ll talk about. I don’t know if there are other things you want to talk about before getting into LDI.
Dr. Darin:
The low hanging fruit is you have to control your environment. That means get rid of all the toxic chemicals in your home. Stop using Windex and 409 and Glade plugins. All these things are chemicals that you breathe in. I think about something like tile cleaner in your bathroom. A lot of these things leave a residue on your tile. Every time you jump in the shower and turn on that hot water, which is steam, it aerosolizes all those chemicals, and now you are getting a big dose. If you are an asthmatic, that can be really bad. Clean up the environment. Get rid of all the toxic chemicals.
Use good quality air filters in your home. Depending on where you live in the world, I live in southern California where our air quality is bad most of the year. As much as we can filter the indoor air, that really helps a lot. Even simple things like washing your bedding every week, reducing dust in the home, these kinds of things can be very simple.
Beyond that, there is a lot of things you can do nutritionally. I think about things like fish oil, which is anti-inflammatory. It’s great for people with asthma. Helps you with allergies.
Vitamin C is a natural mast cell inhibitor. It helps block this histamine reaction from mast cells.
I have a lot of patients that use glutathione. Glutathione is a very important nutrient for detoxification. Very important for the lungs. A lot of people with asthma have low glutathione levels in the lungs.
Magnesium is the one nutrient you burn through the fastest. When you are deficient in magnesium, particularly if you have asthma, your asthma will get worse. One of the ways we treat acute asthma attacks is we give them IV magnesium because it’s a natural bronchial dilator, and it can open up their lungs quickly. If we can sustain their magnesium levels over time, we can prevent them from getting to a point where we had these asthma attacks.
It is a combination of environmental control, looking at these underlying triggers. We have a lot of natural substances we can use to help control allergies and asthma. Things like stinging nettle are great for people who get seasonal hay fever. Quercetin is another great product I use a lot for people with chronic runny nose, itchy eyes, and itchy ears. There are other natural mast cell inhibitors like luteolin, PEA, rutin.
I was talking with Dr. Kelly McCann, who is a mast cell expert. She did a summit last year on mast cells. In the research, there is over 65 natural products that have been shown to help with basically mast cell activation or allergy. In our world, we have a lot of options.
Again, I don’t really want people to get the idea that if you take a bunch of supplements, that will fix the allergy and asthma. It will help your symptoms. If we really want to get to the root of how to change your immune system long-term and hopefully permanently, that is where immunotherapy does a much better job.
Dr. Eric:
Let’s talk about immunotherapy, LDI. How long have you been using it? How can it benefit people with allergies and asthma?
Dr. Darin:
Just as a primer on immunotherapy. It’s immune therapy. In conventional allergy treatment, they do what is called subcutaneous immunotherapy, aka allergy shots. If they do a skin prick testing, and they find you are allergic to dust and ragweed, you come in every single week, and they inject you with dust and ragweed. They are injecting you with the thing you are allergic to, but at a very specific concentration, it starts to build your immune tolerance. Over time, they increase it incrementally, little by little. They get to a point where you are at a maintenance dose, and you will often stay on that dose for many years. That helps control your allergies. Insurance typically pays for it.
It’s a pain because you have to go to the allergist every week, at least for the first handful of months. Then they start spacing out your appointments. That is conventional allergy.
Beyond that, we have sublingual immunotherapy. This has been around for 100 years. The idea is kind of the same as allergy shots. Instead of getting the injections, these are drops you put underneath your tongue.
The way immunotherapy works is through what are called dendritic cells. These are part of the immune system that basically train other parts of your immune system to know what you should be tolerant to. The mechanism by which immunotherapy works is the same.
A lot of people like sublingual immunotherapy because it’s easy. You don’t have to go to the doctor every week. It’s very safe; we have hundreds of studies. In fact, it’s very widely used throughout Europe. It’s their preferential method over allergy shots because it’s also more cost-effective. Unfortunately, here in the United States, allergists get reimbursed for allergy shots, not drops under the tongue, so there is no financial reason for allergists to switch over. I have been doing sublingual immunotherapy for almost 24 years now. I find clinically it works very well. It’s very well tolerated by the majority of people. it’s incredibly safe.
Beyond that, we have what’s called LDA or LDI. The nomenclature gets sticky. Originally, it was called LDA, low dose allergy therapy. This was developed by a doctor in the UK back in the 1960s named Dr. Leonard McEwen. He was an ENT surgeon. He accidentally discovered that if you gave very low doses of these allergens, and you mix them with an enzyme called beta glucuronidase, you can modulate the way your immune system reacted to whatever you mixed it with.
If you look at what conventional allergists use, they are using 1:100, 1:1,000 dilutions of ragweed or dust. Dr. McEwen started with 1:10 million or 1:100 million. Way more dilute. The idea is still the same.
The nice thing about LDA is unlike other types of allergy treatments, which are much more frequent, allergy shots are once a week, and sublingual is usually done daily. LDA, you only do every seven weeks.
Dr. Shrader, who is an American doctor who has studied with Dr. McEwen, calls it EPD, enzyme potentiated desensitization. They were bringing the extracts over from England, but the FDA got a bug up their rear end and didn’t like it, so they put the kibosh on that. Dr. Shrader recreated it in the U.S. with a pharmacy here and called it LDA. EPD and LDA are really the same thing.
Dr. Ty Vincent though, who had been doing LDA in his practice, realized at some point that the way our body responds to microbes is really quite similar to how it responds to conventional allergies. He developed what was called LDI, low dose immunotherapy. That was really more geared toward microbes. The autoimmune reaction to Lyme or strep or candida or mycoplasma or any other microbe. Since then, Dr. Vincent has veered off and created his own extracts. He has his own food mixes and environmental mixes. He calls everything LDI now. Depending on where you are reading this, LDA, LDI, the concept is the same. It’s really the function of what we are treating.
I use the word LDA because we still buy our mixes from a pharmacy that makes it and calls it LDA. Those are for conventional allergies. There are mixes for food, inhalants (mold, pollen, cat and dog feather), and a chemical mix for people who are chemically sensitive. The nice thing about it is there is no testing involved. It’s just a function of do you have the clinical symptoms to suggest that you have food allergies, food sensitivities, environmental allergies? You give the doses.
The way LDA is typically given is as an intradermal injection. Dr. Shrader has a 35-page pink book (because it has a pink cover on it) that has all these rules. This is what Dr. McEwen did in his practice. It’s lengthy. The long and short of it is there is a specific diet you need to follow the day before, the day of, and the day after you get your injection. There are all these other rules about what you can and cannot take in terms of medication. That is the way it was done for many years. Dr. Vincent is a little bit of a cowboy and a rebel. He said, “I wonder what happens if we just don’t follow the rules. Would it still work?” Behold, he found that it did for the majority of people.
In our practice, we do it mostly sublingual. We do it under the tongue. It’s different than sublingual immunotherapy, but we do still administer it under the tongue. We still do the intradermal injection for some people. Clinically, I find it works quite well. The downside to the intradermal injection is it really hurts. It feels like you are getting stung by 100 bees. It lasts for about 30 seconds and goes away, but it’s pretty uncomfortable.
The nice thing of LDA is it is cost-effective, very safe. I get rare complaints of people who don’t tolerate it. If you are looking for strategies that will modulate your immune system over time and cure the allergies and asthma potentially, some form of immunotherapy is likely to do that.
Dr. Eric:
Guessing you have seen people not only with asthma but with IGE allergies that over time disappear with receiving the LDA/LDI.
Dr. Darin:
Yeah. We can monitor this with blood tests. If they are seeing an allergist, they are doing skin prick testing. We see their reactivity over time go down. Treatment can be anywhere from 18 months to several years. People need to understand: When you get on board with immunotherapy, it’s not a quick fix. You’re in it probably for several years.
The earlier you start, the faster it goes. When I treat kids in my practice, and they come in at six years old with eczema and a runny nose, that process is faster, versus coming in at 56 with a lifelong history of allergies, which might take longer. Clinically, we often see improvement within a fairly short time frame.
One of the big differences between sublingual immunotherapy and LDA is time. I find sublingual immunotherapy works a little faster. People feel the difference faster. LDA might take longer. You are getting it almost every two months. It might be that third or fourth dose before you really feel the difference. Sublingual immunotherapy, you’re doing every single day. That daily dose makes a difference.
We are always sitting down with our folks and trying to evaluate what works best for you, your lifestyle, your budget. Unfortunately, all of the non-allergy shots are out of pocket. Insurance doesn’t reimburse for any of it. If you get into that, you need to be prepared that it will be an out-of-pocket expense. If you are fortunate enough to have a health savings account, you can reimburse yourself that way. Unfortunately, there is no codes in the insurance industry that allows us to submit it for insurance reimbursement.
Dr. Eric:
Let’s say someone has asthma, and then they undergo treatment for two years with LDI. They feel like they have been cured. Do they then continue with maintenance treatments every few months? Are they pretty much done?
Dr. Darin:
Generally, no. I do have a few people where they are very well maintained. If there is a high pollen day, and that can happen, it hasn’t rained in a long time, the pollen count goes high, they may start to feel some irritation. In which case they will do over the counter Zyrtec. You might need medication to control it because it’s an unusual event.
Most people, once they are done, they don’t need to continue it. I have a handful of people who get a dose once or twice a year. Sometimes, it’s at their request. “I feel good. I want to make sure I stay good.” There is no downside to continuing treatment long-term. If you are completely desensitized, it won’t harm you. I try to avoid having people spend money on things I don’t think they need. The goal is to get you to a point where you don’t need the treatment anymore.
Dr. Eric:
Before I pick your brain for a few minutes with regards to Lyme, is there anything else I should have asked you that I didn’t ask you about allergies and asthma?
Dr. Darin:
No. If this is something you have been struggling with, get in the hands of a good environmental medicine doctor who understands differently than what an allergist will do. Everyone has their place in the world. Allergists at least in the U.S. will have a very limited definition of allergy. If you want to look at the broader scope, there is a group in the U.S. called the American Academy of Environmental Medicine, AAEMOnline.org. You can do a search and find someone in your area.
Dr. Eric:
Wonderful. Thanks Dr. Darin for sharing that.
Lyme Disease. I work with people with thyroid and autoimmune thyroid conditions, a lot of folks with Graves’ and Hashimoto’s. One question I had is whether you have seen in your practice Lyme and even other coinfections, like bartonella or babesia. Can those microbes be a potential trigger for autoimmune conditions, including thyroid autoimmunity?
Dr. Darin:
Absolutely. I think this is very common, specifically with Lyme, more than other coinfections. Any microbe has the capacity to trigger autoimmunity. We know from the research on Lyme borrelia that it can cause autoimmune reactions to the gray matter and white matter of your brain. It can cause it to your peripheral nerves and joints. I see a lot of people with Hashimoto’s that it seems to have fallen on the heels of having had Lyme exposure. I have not read any research on Lyme and Hashimoto’s specifically, but my clinical observation is it does seem to be a trigger.
This capacity to trigger autoimmunity is different than we think of lupus or rheumatoid arthritis and more classic autoimmune disease. We know from the research that it can trigger those kind of auto antibodies to your own tissue.
The thyroid is a common problem. I have seen a lot of people who have never had a thyroid issue in their life, and after they have Lyme, a lot of people end up with some sort of underactive thyroid, whether it’s Hashimoto’s or straight up hypothyroidism. There is that effect.
It can affect other hormones. Sometimes, it’s adrenals. Sometimes, it’s reproductive hormones. I have seen women who start having irregular menstrual cycles. I have seen a lot of men who have had Lyme and have extremely low testosterone. These 20-somethings who should have testosterone well over 1,000, and it comes back at 200. There may be other explanations as well, but I think this capacity for Lyme to create destruction in our body is quite high.
The way I always think of it is if you are standing on the lake in the morning, and it’s a nice, quiet lake, and a motorboat blows by, the boat can be long gone, but the waves are still rippling in the wake. I think Lyme is that way. It creates this swath of destruction in your body. Even if you’re effective at eradicating the infection, you’re still left with a mess, the hormone mess, the immune mess, sleep. We still have to correct these other issues.
Dr. Eric:
You mentioned earlier on your experience. You took the Doxycycline, the antibiotics. Initially, it seemed to be effective. The second time around, it wasn’t. It’s not just about treating the Lyme infection; it’s improving the overall health of the body. I look at viruses the same way. I think of Epstein-Barr, cytomegalovirus as more of an immune issue than a virus issue.
Dr. Darin:
Yeah. COVID was a great example of this. Look at how COVID affected people. People had no symptoms, some had mild symptoms, and some died. We saw these extreme reactions. If we say the virus is relatively the same- Obviously, COVID mutated over time. Generally, the population was being exposed in the same time period to the same virus and having these extreme reactions.
Same thing with Epstein-Barr or strep or Lyme. Is it really the bug, or is it the terrain? I am not really a subscriber of germ theory anymore. I was a clinical microbiologist before I was a doctor. I think this idea that germs are harmful- There are some germs like salmonella that do create a toxin. Anybody can get sick from salmonella because of the toxin. Most of the germs are out there in our world. We are exposed to millions of bugs every day that don’t harm us. I think there is better evidence that these bugs are here to protect us. Why our immune system starts reacting to these bugs in a negative way, and why these bugs are allowed to create the kinds of symptoms that they do, that comes down to the terrain.
That is everything we talked about earlier. It’s gut health, diet, lifestyle, sleep, toxicity, emotional trauma, all these things that comprise us as humans. If these aren’t in alignment, that is when these bugs become opportunistic, and they start to take over.
Epstein-Barr is a great example. I never really treat it in my practice. Do antivirals work? Not great. This idea that we are trying to kill something that is part of us. If you get exposed to Epstein-Barr as a child, you will have that virus in your body your whole life. You will never get rid of that virus. If it’s reactivated, and you’re having a higher viral load, can you bring it down? Yeah, you can try. Again, if we’re really looking at root cause medicine, what is it that is allowing that virus to become more active? Is it stress? Did you make radical changes to your sleep pattern or diet? Usually there is other underlying factors disposing you toward these things.
When I think about Lyme treatment, it’s not just about killing the bug. That’s part of it, but we have a deep conversation about all these other factors contributing to your health.
Dr. Eric:
The last question I have for you with regards to Lyme is it like Epstein-Barr? Once you have it, you have it. Or can it be eradicated, where it’s completely gone, and you don’t have to worry about it again?
Dr. Darin:
Great question. I think the truth is we don’t really know. We don’t have tests that measure Lyme directly in your body. We look at antibody tests, which are looking at immune reaction. Antibody tests have numerous flaws with them.
I am of the opinion that I don’t think we ever get rid of it. I have plenty of patients over the years who have long periods of being symptom-free. then on the heels of some sort of stress, it’s almost like shingles. When they get really stressed, then shingles comes out. In this case, their Lyme symptoms come back. It seems too coincidental that it coincided with a new tick bite.
It’s always possible. If you live in an area where ticks are endemic, it’s possible that you could get more than one tick bite. More often than not, when I see flares from people who have been symptom-free for a while, it probably was dormant. Your immune system handled it, it lived with you, you lived with it, you didn’t bother each other, but then the terrain shifted. Now that bacteria becomes opportunistic, and you start to experience symptoms again.
Dr. Eric:
From what I’ve read and researched, I agree. I just wanted to get your opinion. Since I dealt with chronic Lyme in 2018, overall, I feel really good. If I didn’t know I had Lyme in the past, there would be no evidence. Sometimes, I feel like weird things, like tingling. Maybe it’s unrelated to the Lyme. Like I said, it’s one of those things that seems like it’s not exactly the same as a virus, but it is intracellular from what I understand. It’s not the same as having H-pylori or other types of bacterial infections. We could go on and on.
For more information, I definitely recommend Dr. Darin’s book on Lyme Disease. Maybe in the future, we can get you back on to talk more in detail about Lyme because we have a lot to cover between asthma, allergies, and Lyme.
Where can people find out more about you? If you could also mention the upcoming summit.
Dr. Darin:
The best way to find me is on my website, DarinIngelsND.com. We’d love for people to join our community. We provide a lot of great information: videos, podcasts, blogs. We have a lot of great information for people dealing with Lyme or other types of chronic illness.
I am going to be hosting an allergy and asthma summit from March 13-March 19, 2023. This is a free event. All you need to do is sign up for the event. If you go to my website, we will have some information posted very soon about that. Join our email list, and we will be sending a lot of information out.
I brought in 50 experts on different aspects of allergy and asthma. I think it’s a great opportunity to hear from different doctors and practitioners around the world on how they help people manage allergies and asthma. We’d really love you to join the event and share it with your friends and family, who also may be dealing with allergies and asthma. People will find a lot of value in it. It will be a great resource of information.
Dr. Eric:
Your book The Lyme Solution is on Amazon or your website?
Dr. Darin:
You can go to Amazon or any major retailer. I know there is not a lot left anymore. Barnes & Noble still exists.
Dr. Eric:
Thank you so much, Dr. Darin for sharing your knowledge regarding asthma, allergies, and Lyme. It was a pleasure chatting with you.
Dr. Darin:
Great. Thanks, Eric.