by Dr. Bill Rawls
The Lyme Q&A Webinar with Dr. Rawls, No. 2 originally aired on November 8th, 2017. Due to popular demand, we’ve shared the video below. We’ve also added a transcript for your reference; you can read it in full, or click on the individual questions to jump straight to Dr. Rawls’ answers. (The video and transcript from episode No. 1 can be found here.)
VIDEO TRANSCRIPTION & QUESTIONS ANSWERED
Are herbs safe for children? – 27:33
Does Stevia help treat Lyme? – 37:08
Tim: Good evening everyone. Welcome to the Ask Dr. Rawls Webinar. This is a live Lyme Q&A Webinar, and we’ve got new content this evening. We had a great turnout at the last one of these we did in September. S we’ll be pulling a few questions that we didn’t get to answer from that webinar, and we’ll have a lot of new content coming into this one from all of the questions that you all sent us during your registration. So thanks for being here.
Dr. Rawls is the author of Unlocking Lyme, a bestselling book all about Lyme disease, a wonderful reference. He’s written about a lot of topics including fibromyalgia, chronic immune dysfunction, and he is the medical director and co-founder of both Vital Plan and RawlsMD.com.
He was also recently featured on The People’s Pharmacy, [an NPR podcast on traditional and alternative treatments]. And he is really passionate about sharing his knowledge and helping people find out how to recover from Lyme as quickly as possible, so they can bypass the kind of long journey that it was for him.
So without further ado, we’ll go ahead and jump into the questions and answers. Dr. Rawls, if you wanna go ahead and join me here, I’m just gonna… Great, good to have Dr. Rawls.[00:01:19]
Dr. Rawls: Thanks, Tim.
Tim: I just wanna start out real quick with… This is a collage. You can see, we got over 1,400 questions sent to us for this webinar, so obviously, we won’t get to all of those questions. But we have read through them all, and we’ve organized them, and Dr. Rawls is going to do his best to get to as many as he can. So we’ll try to keep each question quick. But Dr. Rawls, I’ll go ahead and hand it over to you for a short introduction before we get up to our first question.[00:01:50]
Dr. Rawls: Yeah, thanks. Thanks for joining us, everyone. I’m Dr. Bill Rawls. I’ve been a physician for 25 years, but my greatest credential for helping people with chronic Lyme disease is that I struggled with it myself. [Now I’m] living a normal life, which feels pretty good at this point.
A little bit of background before we get started, just very briefly. A fundamental point that I became aware of in my struggles, in understanding chronic Lyme disease, is understanding the difference between an acute infection and a chronic infection with a microbe.
With an acute infection, someone becomes ill, and becomes sick, from that infection because the immune system isn’t familiar with the microbe. The immune system is blind-sided when the microbe enters a body, whether it’s a tick bite or airborne or however it gets in the body.
The immune system initially doesn’t know what to do with it, and it starts off in a struggle. It ends up in a scuffle between the immune system and the microbe. The intensity of that scuffle is dependent on the familiarity: If the immune system has some familiarity with a microbe, like a common cold, it’s not going to be very intense. If it has no familiarity, like Ebola virus, then it’s going to be very intense.
So one of two things happens. Either the person succumbs to the infection, or the immune system figures out how to control that microbe, contains it, puts it back in the box, and the person regains health. Generally, it’s an infection with one microbe. And that’s key for most acute infections.
With a chronic infection, the person… You know, with a chronic infection, the immune system isn’t working well. It basically has become dysfunctional. So something has disrupted the immune system to allow an infection to perpetuate.
So once an acute infection is contained, the patient can go back to perfectly normal health. But if the immune system becomes disrupted, that infection can perpetuate. Sometimes it can be the microbe that initiates that chronic immune dysfunction. But a lot of times, it’s other factors, too.
So something that’s really interesting when you look at all the tick-borne microbes, it’s pretty unusual for somebody to get acutely ill after a tick bite. Generally, most people don’t get sick with most microbes that they get from ticks. So that would indicate that our immune system is fairly familiar with most tick-borne microbes. So when somebody has a chronic infection with a tick-borne microbe, it’s a strong indication that their immune system isn’t working properly.
So that’s a fundamental point that you need to recognize in looking at the answers to all of these questions—that chronic immune dysfunction is the underlying problem with chronic Lyme disease and so many other chronic conditions. So, Tim, I’m ready for questions.[00:05:37]
Tim: All right. Sorry about the little gaps sometimes when we switch camera or mic. There’s a little cut-off, so thanks for bearing with us, everybody. Yeah, really good background information that kind of applies to all the questions that we’ll be dealing with tonight. And we’ll go ahead and get started with our first one.
Dr. Rawls: When you look at microbes in the world, they typically specialize with a way of transferring from one host to another. So some things are respiratory. Some things are tick-borne, or [from] other kinds of biting insects. But it doesn’t mean that’s the exclusive way that the microbe can transfer.
So they have found Borrelia in mosquitoes. There are questions of whether it could be transferred by sexual contact or in utero. But that’s not the absolute way… That’s not the most common way that it happens.
So sure, it’s possible, but more commonly, you’re going to find that the microbes are transferred mainly by ticks. Tick-borne microbes, like Borrelia, have specialized in transferring by the tick route more than anything else.
Dr. Rawls: Yeah. We have a list of the ones that are most common. The most common coinfection is mycoplasma. Bartonella is next to that. Down the list, you have Chlamydia, which can be transferred by ticks. But most of the time, it’s already there. And then the big ones that people worry about, as far as being more virulent or higher potential for causing disease, are Babesia, Rickettsia, Anaplasma, and Ehrlichia.
But there probably are a lot more microbes out there than that. We find that even one tick species can carry, literally, hundreds of different kinds of microbes that can infect humans. So we’re really just scratching the surface in our understanding.
And even when you talk about Babesia, Rickettsia, and some of the others, you’re talking about different microbes and different strains. There are many species of each of those microbes, and almost an unlimited number of different strains.
So one strain can be much more virulent or disease-causing than another. Typically, if a microbe is more virulent, someone is going to have more of an acute infection at the beginning. And a lot of people that get bitten by ticks, don’t have a very strong acute infection.
It’s really interesting. If you go back to the original Lyme, Connecticut story, and Willy Burgdorfer who was analyzing the specimens from the children who got acutely ill, and some adults too, he decided to pick out Borrelia as the microbe that he thought was the cause of it.
Very interestingly, almost all of the specimens also had a species of Rickettsia. And some people are thinking now that Rickettsia was the thing that initiated those infections, and then it became chronic with Borrelia. We now know that those people probably had other microbes on board too.
So when you look at microbes in general and this whole concept of chronic Lyme disease, you’re always talking about more than one microbe. Chronic infections are always multi-microbial. Sometimes, those microbes come from ticks. Sometimes, they come from other sources. A lot of people have microbes on board. We basically collect microbes throughout our lifetime.
So how acute the initial infection [is] depends a lot on what kind of chronic infection will be there. Once that tug-of-war, that vicious cycle, of chronic misery gets going, it’s never one infection. So I always come back to the point that you really have to think about treating the immune system.
Restoring immune function is key to overcoming chronic Lyme disease. And that’s something that became fundamental in my recovery: looking at the things that disrupt immune function, and restoring the ability of the immune system to take care of the microbes. Part of that is diet, lifestyle, getting better sleep, etc., but herbs were really fundamental.
The thing that’s really wonderful about herbs is they’re safe. You can take them a long time. They suppress the microbes, but they also have the effect of boosting immune function, which is really extraordinary. That’s the key thing about the herbs that really, really matters.
So building that restorative base is so important. And I see so many people who skip from one thing to another, trying all of these heroic therapies of antibiotics and ozone. They’re not getting well. They’re spending a fortune, and if you’re not creating that restorative base of rebuilding the immune system, you’re just not going to get where you need to go. So really important: immune function, and getting the immune function back to working where it should be.
Dr. Rawls: It goes back to just how we teach people in medical school. When you look at all of the medical systems, they’re focused on dealing with acute problems. So we’re really good at acute infections. We know how to prevent devastating things like smallpox, and we know how to contain Ebola virus. We can treat acute pneumonia.
So when you look at these acute, devastating things, we do a really great job. But doctors don’t understand that fundamental difference between an acute infection and a chronic infection. So when you start pounding people who have a chronic infection with antibiotics, because their immune system has been disabled and is compromised, what you end up doing is pounding their normal flora and making their situation worse.
So it’s just a fundamental thing. When we look at all of chronic illness, we try to treat a chronic illness acutely, and it just doesn’t work very well. And it’s something that we need to readjust in our system, of how we’re focusing on the difference between acute illness and chronic illness.
With chronic illness, you have to look at the causes. You have to look at the underlying chronic immune disruption that’s occurring, so that you can restore the ability of the body to take care of itself. I mean, that’s really important.
I mean, even when you look at an acute infection with a microbe, and you treat, like, an acute pneumonia with an antibiotic, the antibiotic helps knock down the numbers of the microbes. But it’s not what overcomes the infection. It’s the immune system that gains ground and overcomes the infection. So if you don’t have a robust immune function, and you develop pneumonia, you’re probably not going to survive, no matter how much in the way of antibiotics you take.
Dr. Rawls: Absolutely. When you look at testing for microbes, again, what we’re testing for are acute infections. All of the testing, whether you’re looking at serology, which is looking for antibodies, or whether you’re doing DNA testing, which is looking for particles and RNA of the microbe, then you’re looking at how to diagnose an acute infection when there are high levels of the microbe in the blood.
So when you look at these stealth microbes that are deep into tissues and they’re suppressing the immune response, and the numbers of these microbes are in very, very low, very low concentrations, it’s really hard to find them. So we really don’t know how good or how bad any testing is for chronic infection because we really don’t have much of any way to evaluate it.
So it can be misleading to have all the symptoms of chronic Lyme disease and have a negative test. In my opinion, the testing just isn’t good enough. If someone has all of the symptoms of chronic Lyme disease, they probably have Borrelia. They definitely have microbes on board, and they definitely have chronic immune dysfunction.
So testing has marginal value, quite frankly. We’ll get better at it, and I think what we’re gonna find as we get better and better, is that an awful lot of people are carrying these microbes but aren’t sick.
Dr. Rawls: Yeah, that’s a common question. CD57 is a small subset of mature, natural killer cells. When you look at all these infections that we’re talking about, what I call stealth microbes—which includes both viruses and microbes like Borrelia, mycoplasma, Bartonella, Babesia, all of these—a common characteristic is they’re intercellular. They infect white blood cells and exist…
The cells that go and get the abnormal cells in the body that have been infected by microbes are natural killer cells. So the microbes are doing everything they can to manipulate the immune system to suppress [the natural killer cells]. So CD56 is the normal population of natural killer cells. CD57 is a mature subset.
You mostly find CD57 with viral infections, like Epstein-Barr virus (EBV), CNV, other kinds of things, or also other intercellular microbes. But again, these microbes are trying to suppress CD57, so it has been found that people with chronic Lyme often have a low CD57.
All the literature that I’ve reviewed, however, suggested that [low CD57 levels are] not good enough to actually pin the [Lyme] infection. Basically, [the research] says that all it tells us [is whether] you’ve got intercellular microbes that are suppressing natural killer cells. But even if CD57 cells are normal, it doesn’t tell you that the microbes aren’t there. They could still be there and just not in high enough concentrations to actually suppress that subset of natural killer cells.
Dr. Rawls: Yeah, I think that’s a loaded question. There is no absolute, best treatment for Lyme disease.
You give antibiotics to somebody with acute infection with Borrelia, and it’s going to knock down the numbers enough that it may help the immune system take control. Same thing with Rickettsia or others. But most of the people don’t catch it in that acute phase, so they end up with a chronic infection.
So when you look at the fundamental thing that’s wrong—chronic immune dysfunction— you have to not only suppress the microbes, you’ve gotta break the cycle. You do have to suppress the microbes, but you have to do it for a long time. And at the same time, you have to boost the immune function.
So the problem with using antibiotics long-term is that these microbes are a lot more protected than our normal flora. So you hit the normal flora harder than you hit the stealth microbes, and you end up causing more problems, contributing to the immune dysfunction and really destroying the gut flora, which causes a lot of GI problems.
So building that foundation—building the foundation of restoring the healing capacity of the body, restoring immune function, restoring homeostasis for the balance of hormones in the body—is what it’s all about. You do that by one, reversing the factors that initiated the immune dysfunction. And that includes…
There’s so many factors: dietary, emotional, toxins. I can give you a huge variety of stories of people with different immune system disruptors that became ill. So you’ve got to address those things. And in my opinion, a foundation with herbal therapy is really, really important, because herbs suppress the microbes but at the same time, boost natural killer cells in other parts of the immune system, reduce inflammation, rebalance hormones, restore homeostasis. So herbs are doing a lot.
And so I think it’s very important to build that foundation. Now, healing takes time, so sometimes, using symptomatic therapies—sometimes that is drugs, sometimes that’s herbs just to help control symptoms like sleep, like pain, and all the neurological symptoms—can sometimes be helpful.
That top category of heroic therapies can be valuable in someone who has a more virulent microbe or just isn’t getting well. And so occasionally, there is a place where antibiotics or other kinds of heroic therapies like ozone, pulsed electromagnetic therapy is looked at as far as its value. So there are other things out there.
But if you’re not building that foundation of restoring immune function, the chances of getting where you want to go are much more limited. So there’s not any one thing to do. It’s lots of little things done persistently over time, and until you get where you wanna go with restoring immune function.
Tim: Great. There it is everyone. That’s the overall philosophy. All your questions have been answered now. But really, that is huge underlying foundation, in a kind of principle to everything that Dr. Rawls explains as far as how to overcome this.
Dr. Rawls: All right. That’s the problem with antibiotics. And I see the people that get trapped with antibiotics all the time, that are suppressing the microbes, but not restoring immune function. And people typically plateau or get worse with an antibiotic because of several things.
One, the microbes are starting to develop resistance to that single ingredient antibiotic, that single chemical. Two, the antibiotics start disrupting immune function, which is disrupting the normal flora, which inadvertently affects immune function. So as soon as people go off the antibiotics, they get sick again.
So it ends up being this endless cycle of one antibiotic after another, trying new antibiotics. And you get to the point where the antibiotics just don’t work anymore. The fundamental difference between an antibiotic and an herb with antimicrobial properties is the herb is a spectrum of chemicals.
You know, the plant is creating these chemicals to protect itself from these kinds of microbes. But the plant is doing it in such a way that it’s not disrupting its own normal flora, and therefore, most herbs don’t disrupt normal flora. You can take them a long time. Most of them actually help balance the gut. And so you can take herbs for years, many years.
I’ve been taking herbs almost continually, different herbs at different times, for about 10 years now. And it just keeps getting better every year. So in my opinion, herbs have to be your foundation. They’re really, really important.
Occasionally, people do get good results with antibiotics on top of that, but it’s unusual, I think, for someone to get well completely from an antibiotic alone. It happens, but it’s because their immune system is restored or rebounds, not as much because of the antibiotics.
Dr. Rawls: No. The herbs are so different than the antibiotics, I think any of your herbal combinations… You know, there are many standard herbal combinations for Lyme disease. And it’s generally never one herb, it’s a collection of herbs, because you’ve got a lot of different microbes there. You’ve gotta look at potential pathogens in the gut beyond the things that are tick-borne microbes. So you’re balancing a lot of things.
And so we combine different herbs that have different effects. Some have more of a gut effect. Some of them have more of a systemic effect. And then, you balance that with immune-modulating herbs. Immune modulating herbs are herbs that have the effect of boosting natural killer cells and getting that immune system back online. So that foundation is really important, but it’s really irrelevant of the antibiotics.
I would suspect that people would get better results with herbs and antibiotics than antibiotics alone. But I can’t tell you that people get better results from herbs and antibiotics over herbs alone.
Dr. Rawls: You know, there’s not a lot of literature on using herbs in kids, but we do know that historically, herbs have been used with kids for thousands of years. So most kids that are using herbs tolerate them extremely well. The long-term safety of any herb is high.
You’ve got to look at the fundamental difference between herbs and synthetic drugs. A synthetic drug is an artificial chemical that is introduced into the body that our system has never seen before. There’s a lot of similarity with plant-based chemicals; many plants have similar or the same chemicals. And humans have been exposed to these things for all of eternity.
So it’s interesting that for most herbs, we recognize these things. They have an extremely low level of toxicity. One of the interesting things about herbs compared to drugs is, most drugs actually have an adverse effect on liver function, where many, many of the herbs—the restorative herbs that we’re using—actually enhance liver function and improve liver function.
So the herbs have a real advantage. They’re not as potent, but for these kinds of infections, you may not need that potency. [Do you need antibiotics for] acute pneumonia? Absolutely. But not as much for this. But when you look at the herbs, there’s something called the LD50 [Lethal Dose 50] that tests on rats to look for the toxic dose.
You know, they use this for drugs, but they also use it for herbs. And they’re looking for the dose that terminates the rat, basically. And then they look at the equivalent in humans.
So, you know, most herbal therapies, we’re talking about 500 milligrams or so of herb. But the toxic dose for most herbs is somewhere between 15,000 and 30,000 milligrams a day. So the toxicity is really low for the majority of herbs, especially these restorative herbs that we’re using.
There are herbs that are toxic, but generally, when we look at this restorative approach of getting well, we stay away from any potentially toxic herbs and look for things that can be used safely in most people long-term.[00:30:20]
Tim: Yeah, I think that’s a really important thing to bring up because a lot of folks who’ve never used herbs, or who’ve only heard about herbs in the news or through other folks, think about them as, “Be careful with the herb-drug combinations.” Which you do with certain herbs, but there are so many herbs that are really quite safe to use and are not that sort of an herb. So it makes it a lot more approachable.[00:30:45]
Dr. Rawls: Yeah, it’s true. And not to say that people don’t occasionally have allergic reactions to herbs, but generally they’re pretty mild. And most people tolerate the herbs quite well. The biggest problem that we see is a lot of people have gut dysfunction, and the dry herb powders can irritate the gut. So we usually suggest that people use coconut milk and things that are soothing to the stomach, just so they absorb the herbs better.
Dr. Rawls: Well, there are a lot of herbs that work. And you know that Stephen Buhner was the one that started really paving the way, pioneering the use of herbs for Lyme disease in 2005. I read his work. Since then, a lot of people have looked at using herbs for Lyme disease and other conditions that are associated with chronic immune dysfunction.
I think that’s really important. You know, fundamentally, I see fibromyalgia, chronic fatigue, and a lot of other chronic illnesses as basically this same thing of chronic immune dysfunction and underlying stealth microbes that are flourishing and causing misery. So it varies from microbe to microbe.
Yeah, the nice thing is, there are lots of herbs out there that work. So the reason for using that basic foundation or set that I’ve recommended so far is that we know a lot about those herbs. They’ve been used by thousands and thousands of people with good results. But there are many herbs outside of that that work.
So the choices are almost unlimited. Occasionally, people do develop tolerance to an herb. I found that was the case after several years myself. And instead of stopping the herbs that I had, because you still get so much benefit, I just added new herbs.
But when you look at all the herbal traditions that have been used for treating infection-like illnesses, wow, we have so many choices. I mean, there’s Anamu from South America that’s great for mycoplasma, and Mullaca from South America. There is Cryptolepis. There is Alchornea. Neem has some wonderful antimicrobial properties.
If you start developing tolerance, then you add herbs to that or switch around to other herbs. But quite frankly, the herbs that I promote in my book and that we use in our products, if somebody told me tomorrow, “You just can’t get those herbs anymore. They’re just not available.” I’d say, “Fine, no problem. I’ve got this whole set of herbs over here that I can use.” But complementary herbs, looking at how they affect different microbes and how they affect the gut and that sort of thing, is important.
Tim: And we have gotten a lot of questions about Dr. Rawls herbal protocol. We’re not focusing on that tonight, but we will send an email to folks that are interested in learning more about that. So keep an eye out for that. And if you are somebody who’s already on Dr. Rawls’ herbal protocol and you’ve got a specific question about the protocol, please feel free to reach out to the RawlsMD support team.
Dr. Rawls: I think that just goes into general restorative care. Gut function is remarkably important, and one of the first things we embark on is restoring gut function with patients. Some herbs are really beneficial for that.
I recommend berberine very often because it helps stimulate the liver. Andrographis, one of our primary herbs, helps stimulate the liver. So moving toxins through the liver, out of the body, and getting gut function working is very important.
Another thing that I recommend commonly is Chlorella. Chlorella is a freshwater algae and it has some really nice properties of detoxifying and deodorizing, but it is also a wonderful gut healer. So that’s something we commonly recommend as part of our primary protocol.
Tim: Great, and thanks everyone for bearing with us. It’s cutting out a little bit here and there with the video. But it’s just the nature of the platform sometimes and being able to communicate with all of you all over the world. So thanks for sticking with us.
Dr. Rawls: Yeah, it’s a common question. It intrigues me that as many wonderful herbs out there that do have systemic antimicrobial properties that are useful in Lyme, people have gravitated toward the one herb that doesn’t.
And people are getting this because somebody in some lab took some Borrelia cyst in active forms and dunked them in a test tube with Stevia, and all the cyst forms died. And therefore, they determined that Stevia treats Lyme disease.
But here’s the fundamental flaw in that. People use Stevia as a sweetener because the Stevia sides are not absorbed. They affect our taste receptors for sweet on our tongue, then pass right through the intestine and are not absorbed through the intestine. There are some very good studies documenting that they are not absorbed into the body.
So how can something that’s not absorbed into the body be useful for treating an infection? So just because Stevia kills Lyme disease in a test tube, doesn’t mean that it’s going to kill Lyme disease in the body. So I wouldn’t put Stevia high on the list for a treatment for Lyme disease. There are so many other herbs that are so much better.
Dr. Rawls: Yeah, we’re starting to see things in the media about cannabis being a treatment for Lyme. I think it has value, but I wouldn’t define it as a treatment alone. Cannabis is a whole different lecture. I personally never used marijuana because I was a physician and just didn’t feel like I could get away with it.
But through exploring herbals, I’ve become very familiar with the plant and studied it very, very extensively. You have different varieties of cannabis. The variety that we call marijuana predominantly has an enzyme that takes precursor chemicals and converts them into THC.
When someone takes THC into their body, it binds to endocannabinoid receptors very, very tightly. The endocannabinoid system is very important for feeling well, and for the immune system working well, and for everything happening in the body.
So when you take THC and it binds to that receptor very tightly, then you have an exaggerated or a euphoric response. But there are some concerns about THC adversely affecting brain functions. Compared to alcohol, it’s probably a lot smarter to go fire up a joint than it is doing alcohol—not that I’m promoting marijuana.
But for medicinal purposes, it’s very intriguing, and especially another variety of cannabis called hemp. Now hemp, you have the same precursor substances that are converted by an enzyme into CBD. CBD doesn’t bind to those receptors as tightly, so it has the effect of causing you to generate more endocannabinoid receptors. And the effects it has are more in controlling pain and actually enhancing some immune functions. So it doesn’t have any euphoria.
CBD from hemp is legal in every state. It is being grown here in North Carolina for the purpose of producing CBD for medicinal purposes. You do not get high at all from CBD. It has no use for that, but it can be a wonderful immune modulator. It can help with pain and in some people, it can help with sleep.
The only downside about CBD from hemp right now is that the DEA hasn’t really defined their stance on cannabis at all. So even though it’s legal to grow hemp in many states, and it’s legal to possess it in any state, according to state laws, the national laws are still fuzzy. But they are not affecting transfer of CBD from hemp across state lines. You can order it on the internet.
But because of DEA stance, it’s really kept the price of it very high. Most people need 15-30 mg of CBD, one to three times a day, to see a benefit. To determine the cost per milligram of CBD in a product, simply divide the dollar amount by the total number of milligrams of CBD in the bottle. You should be able to find a high-quality CBD oil for less than 15 cents per milligram of CBD. You do one or two dropperfuls, once or twice a day.
The downside of CBD is you can develop tolerance. So I think it’s more for intermittent use for controlling pain. And again, it can get really expensive if that’s the primary means of controlling pain.
Hemp also has other chemicals in it that are immune-modulators, terpenoids. And like most any other herbs, it’s an herb. So it does have some nice immune-modulating properties. I wouldn’t put it on the list of being a treatment for Lyme disease, however.
In states where it is legal to do medical marijuana, people are getting a little bit more benefit from products that are high CBD but have a little bit of THC in them. With a low THC, you don’t get the euphoria that people going for recreational use do. So I think it’s another thing to put in your toolbox, but again, not a cure of Lyme disease.
Dr. Rawls: This one is a little bit ill-defined, and it’s very individual. If you look at people with chronic illness, a lot of people are low in magnesium. But what we’re testing is the red blood cell level of magnesium, not necessarily the body store. So we really don’t know how good that testing is.
Most of those people are not eating well, or they’ve got gut dysfunction so that they’re not holding all the magnesium. So taking magnesium can be beneficial. It does make some people feel better. The best form of magnesium for just general supplementation is magnesium glycinate.
Glycine is an amino acid. If you take the glycinate form of magnesium, it will affect your stools less adversely. You won’t get loose stools. Some people actually use magnesium to help with constipation. The best form of that is magnesium citrate.
But the problem with magnesium is a lot of people with Lyme disease—it happened to me, whenever I took magnesium as a supplement, I got muscle cramps pretty significantly, especially in my legs. I don’t know the reason for that. Some people have suggested that the microbes actually thrive on magnesium. We know that magnesium is a key mineral that Borrelia needs to survive.
But it could be that it’s just causing an imbalance between magnesium and calcium in the muscle, with too much magnesium over the calcium. And that could be causing the muscle cramps. So it’s very individual.
I don’t think it hurts to try a dose of magnesium glycinate. It can be calming. It can help with sleep. The normal dose is about 400 milligrams a day. But if you start having muscle cramps, either back off or stop the magnesium. If you’re using it for chronic constipation, some people find benefit with magnesium citrate. But that often can cause the muscle cramps.[00:46:48]
Tim: So just to make sure I understand you, and everyone else does as well, I know a lot of people take notes during these, magnesium citrate is what you recommend for constipation. And then magnesium glycinate is what you’d recommend for what purpose?[00:47:05]
Dr. Rawls: For just relaxation, feeling better. It’s calming. Magnesium is nice because it has some calming influence on the nervous system. And some people with muscle cramps can take magnesium and it helps. I’ve just found it to be wildly individual. You just have to try it out.[00:47:28]
Tim: Yeah, and then there’s the warning like you were saying, potential issues with doing a very high dosage of it.[00:47:36]
Dr. Rawls: Right.
Dr. Rawls: Silver does have antimicrobial properties, and that’s been well-known for a long, long time. So does mercury, you know? And mercury was used for a very long time as an antibiotic for treating infections from the Middle Ages on. Then we found that mercury is really toxic to tissues.
Silver is not as toxic, but the body has no use for silver. And it really doesn’t know what to do with it. So the silver does accumulate in tissues. We don’t know how harmful that really is, but we do know that people accumulate it in their tissues. They have a dusky, gray-colored skin after using it for a long time. And that can persist for a very, very long time.
So we don’t know enough. We may be taking some unknown risk. I always have to question why would we use something, this metal that we can’t get rid of very well? You know, and we’re spending all this time trying to get rid of heavy metals like mercury and cadmium in the body. And here, we’re gonna dump silver on top of it instead.
And it can interfere with other metals in the body like zinc that we do need for metabolic processes. It can block some enzymatic processes in the body. That’s why it’s working as an antimicrobial. It’s blocking enzymatic processes in the microbes that it’s substituting for other metals. So it’s bound to happen at a low-level on our tissues too.
Why use something like that that has this potential high toxicity when you’ve got all these great herbs that actually work better? The herbs have antimicrobial properties, but they also have immune-modulating properties, they boost immune functions. Silver most certainly does not do that.
So if you give me a choice, I’m going to take the herbs. I never took silver. The only place that I would say is an exception is topical use. We’ve been using silver for years, and it can be good for skin conditions. It’s good for healing burns and preventing microbial infections. But then you’re not really absorbing it into your tissues to any significant degree. So I’ll place my money with the herbs.[00:50:38]
Tim: Right. So if we go back to therapeutic pyramid here, silver would fall under the heroic category, correct?[00:50:49]
Dr. Rawls: Yeah, I would put it there. But again, why not just use a traditional antibiotic instead of the silver? And you’re not getting quite as much of an antimicrobial effect with silver as you are with regular, synthetic antibiotics. Silver can still disrupt the flora in the gut too.[00:51:14]
Tim: Yeah, so while silver has some great antimicrobial properties, it does fall into one of those system disruptors and it’s potentially a toxin to your body.[00:51:25]
Dr. Rawls: Potentially, yeah. Potentially, it could add to the toxicity of the body.
Tim: Another one of Dr. Rawls’ great summaries of how to approach health, looking at those disruptors and minimizing those. Okay, great. Well, the next question, Dr. Rawls, we’ve got several questions on Candida. So this is a little bit more in depth here, just bear with me while I read this.
For example, after roughly six months of treatment, I do lab tests and live blood analysis on a frequent basis. I now have a systemic fungal Candida flare up in the blood,” that she did not have before. “I wonder if Lyme microbes help to keep fungal bugs in check, and now that I’m losing the bad bugs, other ones like Candida are getting the advantage. What do you think?”
Dr. Rawls: No, no. Yeah, I got it. Yeah, there are a lot of people that question live blood analysis. I’ve tried to explore that. I know that there are hucksters out there. There’s no doubt about it, that they have been exposed. Maybe there are some people that really do well with it.
But I think one thing that’s important is, you’re not gonna see many of these microbes in the blood. They typically are very, very deep in tissues. And when you look at the disruption of the microbe biome, it’s a pretty delicate balance. Depending on how you kill the microbes, it could certainly increase the presence of Candida and other yeasts. And yes, you can see spill over into the blood with that, especially if you have leaky gut.
That’s a nice thing about the herbs is that they’re suppressing the pathogenic yeast like Candida, but not suppressing the normal yeast in the body. Candida overgrowth occurs because the normal kinds of yeast in our gut… We all have a variety of different yeasts, and some of them are very favorable, that are actually suppressed pathogenic yeasts like Candida.
You take high doses of antibiotics and you’re gonna kill the normal flora off, and you’re gonna allow overgrowth of the Candida. Treat the Candida with the antifungals like Diflucan, and you’re going to suppress the Candida, but you’re also going to kill off all the normal yeast that have to be present to suppress the Candida.
So it is very complex. And the harder you hit things in the gut with synthetic antibiotics, antifungals, etc, the more disruption that you’re going to get. And yes, you could get some spillover of that into the blood.
That’s a really nice thing about the normalizing effect of the herbs, but it’s not the herbs alone. It’s a restorative diet. It’s restoring normal gut function. It’s using herbs like berberine that help suppress the yeast and allow the normal flora of the gut to flourish so that you can get back to a normal balance, which is really essential for overcoming chronic Lyme disease or any other chronic illness. It’s super important.
Dr. Rawls: Yeah, neurological aspects are common. And I think it depends on the strains of microbes, the species of microbes, and which collection of microbes a person has. Some people tend to have more skeletal symptoms. I did have a range of neurological symptoms, but my predominant symptoms were involvement of the heart, joints, and muscles.
Neurological symptoms tend to be very stubborn because the nerves and the brain are protected by the blood-brain barrier. So once those microbes get across that barrier, it’s a little bit harder to treat. Some synthetic antibiotics cross [the barrier]; many do not. Most of the components of the herbs do cross, but healing takes time. And neurological symptoms are by far the most stubborn.
So when you look at this restorative approach of restoring normal immune function using herbal therapy, it’s a long-term thing. And it can take a good while for the symptoms to clear. Sometimes, other herbal therapy or even drug therapy can help control the symptoms in that process.
So in other words, we’re not treating the symptoms directly, we’re treating the underlying causes and gradually wearing these microbes down by attrition. As that happens, tissue functions are restored to normal.
Are there things that you can do to enhance that effect? Certainly. You want things that cross the blood-brain barrier. And fatty things go across. So taking a good dose of omega-3s, fish oils. You have to be a little bit careful with fish oils. It’s been found that if you use more than 6 grams a day, then you can actually thin the blood so much that it increases risk of hemorrhagic stroke or blood vessels rupturing.
But most people aren’t using enough fish oil. A capsule a day just isn’t enough. In my recovery, I was typically using three or four of those, or the equivalent of six or more pills a day, and combining that with other things that cross the blood-brain barrier.
You hear a lot about turmeric and curcumins, or curcuminoids. Curcumins are the water-soluble chemicals [in turmeric], but there are a lot of other things in whole turmeric. The oil-based chemicals are called tamarinds. And there’s a lot of interest in studying tamarinds and how they cross the blood-brain barrier and help reduce symptoms.
A lot of the herbs are crossing over. We’ve also found that a coconut extract called monolaurin can be very good for crossing over to the brain. CBD, because it is a fat-soluble substance, and the terpenoids that are also present in the hemp cannabis, can cross over and can be wonderful for reducing headaches, calming the neurological system, restoring balance.
One of the things that has been recently explored with CBD is the effect that it has on controlling seizures in children. So it has a really nice effect.
There are some herbs that we call affector herbs beyond CBD that have more of a specific effect. Bacopa is a calming herb that has wonderful effects on restoring brain function. There are other herbs like Gotu Kola and Passion Flower that are really wonderful for calming neurological function. Ashwagandha is an adaptogenic herb that is really nice for calming neurological functions, calming brain responses.
So those kinds of herbs can not only help restore a normal balance, they can also just help with some of those nagging symptoms.
Dr. Rawls: Yeah. I just wrote a nice article on EBV, and I encourage everybody to read it. I did a pretty deep dive on all the current research on EBV, and there is a lot of interesting stuff out there. When you look at chronic EBV, you’re talking about reactivated EBV.
Ninety-five percent of the world’s population is carrying EBV. So the chances that you’ve got it are high. Most people get exposed to it in childhood and they don’t know it. It’s only if you don’t get exposed in childhood and catch it later, like when you’re in college, that you would get mononucleosis.
But most of the people with chronic illness, if they’re seeing EBV, it’s because their immune system has become depressed and it’s allowed this microbe, this virus to flourish again. So many of the flu-like symptoms that people have may be due to EBV, but we also have other [microbes]. There’s CMV, HHV-6 and 7, and a whole list of other viruses that can act similarly to EBV.
Treating EBV with antivirals works with an acute infection. And that was something really interesting that I found in the research. They’ve actually found that antivirals just aren’t effective for chronic infection. Apparently, with an acute EBV infection, the virus uses an enzyme called DNA polymerase to replicate itself. It uses the machinery of the cell and it uses its enzyme to commandeer the cell so that it can produce replicas of itself.
Apparently, DNA polymerase is what all the EBV drugs are blocking. So it works for acute infection. It works for relapses of some kinds of infections like herpes simplex or ulcers, the drugs still work. But EBV apparently stops using DNA polymerase and starts using other mechanisms for reproducing itself in a chronic reactivated infection, so the drugs don’t have any effect.
So again, it’s not just EBV. It’s all these different microbes. And the fundamental thing that’s going on is chronic immune dysfunction. So the best way to address it is addressing the chronic immune dysfunction.
A lot of herbs do have some antiviral properties—Reishi mushroom, Chinese Skullcap, Andrographis. There are many of them that actually have suppressive effects on EBV and also help restore those natural killer cells. The herbs are the key to getting rid of these things and controlling them.
Tim: I realize we should clarify for everyone that Epstein-Barr virus, in case you’re not familiar with EBV, Epstein-Barr virus. And once again, you can see that article at RawlsMD.com. You’ll be able to find it and read a lot more about that. That’s a really interesting topic to learn more about.
Dr. Rawls: No, that’s really doubtful. I think it’s just… It’s more apt to be associated with microbes like mycoplasma, Bartonella, and others. Parasites aren’t as common as people think. Well, when you say parasite, any host-dependent microbe is technically a parasite. So Borrelia, Epstein-Barr virus, all the rest of them are parasites.
But when people say parasites, they’re typically talking about intestinal worms. There are things that would classify as a parasite, like different kinds of Protozoa, like toxoplasmosis, that can occur chronically, that can reproduce in the body. But when you look at worms, they don’t reproduce in the body.
So we do get eggs from worms from time to time. You have to have a fecal-oral connection. You have to ingest the eggs. So occasionally on uncooked lettuce or leafy greens, we may occasionally pick up the eggs.
But to have an infestation, you’ve gotta have a lot of eggs. You’ve got to ingest a significant number of eggs. The eggs have got to hatch. They go through a cycle. They become an adult, attach to the intestine, and then they start passing eggs, which pass out of your body, into your stool. But they do not hatch and re-grow into new parasites.
So eventually, whenever that worm, that multicellular worm reaches its adulthood and lifespan, it dies and passes on through. So if you’re only occasionally getting an egg, you’re gonna have a very, very low burden of parasites. And they’re not going to do that much.
It’s only in third-world countries that we see really heavy burdens of parasites, because people are continually being inoculated by contaminated water. And they do get heavy loads of microbes.
But interestingly, when I was really looking into this particular topic, I found that if you look at third-world countries and burdens of parasites, intestinal parasites in those places, it’s only people with depressed immune function that have a high burden. People with a really robust immune function, even ones getting regular contamination and ingesting eggs, aren’t getting infestations of parasites. It’s a really interesting fact to find.[01:06:55]
Tim: Always comes back to that immune health, doesn’t it?[01:06:59]
Dr. Rawls: Yep.
Dr. Rawls: Never give up hope. One thing I don’t do is give false hope. But for chronic Lyme disease, it’s been an experience to go through it myself. It’s been quite a ride. I wouldn’t recommend it for anyone, but I’ve learned a lot, and I’ve become a better doctor because of it. And it’s a struggle. There’s no doubt about it.
But the turning point in my life was when I stopped relying on other people to make me well and took control of my own health. When I took accountability for my situation, when I studied it and recognized that the problem was this underlying dysfunction of my immune system, that I wasn’t kicking off these microbes, and I started doing the things that I needed to do to restore my immune system, that’s when I started getting well.
And I took control of my situation. I didn’t leave it in the hands of another person, a doctor, or anyone else. You know, when I used doctors, I was using them for a purpose. I needed something specific from them, a lab or whatever. But I took accountability for my own recovery. And that’s when I started to turn a corner.
So I’ve helped a lot of people do that since that time. And the really nice thing about working with chronic Lyme patients is they’re not as sick as lot of other people. I see illness as a continuum. I think that all of the chronic illnesses are closely related.
I think all chronic illnesses are based in chronic immune dysfunction and disruption of the normal healing pathways in the body, and these underlying stealth microbes that we all collect. Everyone has a certain number of these things. So when you look at all these illnesses, they’re related. Fundamentally, they’re the same.
The different illnesses may be associated more than anything else with the genetics of the person, how their immune system has become directly disrupted, what kinds of factors came together, and which microbes they’ve picked up in their lifetime. But those things progress, you know? People with chronic Lyme and fibromyalgia and chronic fatigue aren’t as sick as others.
But we’re finding that there are a lot of connections between these microbes and other illnesses—Parkinson’s, Alzheimer’s, Multiple Sclerosis, all the rest. So if I can catch someone when they’re at a point of Lyme disease or fibromyalgia, before they’ve got some of those more desperate conditions that are much more progressed, then there’s a high probability that they can completely get their life back, not to say that there’s no hope with any of those situations, though.
When I work with people with more progressive illnesses, if I can get them to take the steps to restore the body’s normal capacity to heal itself and to restore normal immune functions, then it’s amazing what a difference it can make. So I never give up hope on any individual. I think there’s always, at any point, things you can do to make your life better.
Dr. Rawls: Care about them more than anything else. Lyme disease is frustrating because people don’t always look ill. And people look at them and go, you know, “What’s wrong with you?” You know, it’s often not an obvious disability. So there’s a lot of frustration.
One of the things that I think is important for loved ones is to just have patience and recognize that that person is struggling, and give them space. Give them space to get well.
You know, I had to sleep in a separate room for a long time because I had to be so restrictive of my sleep habits. I had to go about life completely differently. I had to balance things very differently. Our income was constricted, so we had to adjust to that. And having somebody that recognizes those things is really important for that whole wellness process, really important.
Tim: Awesome. Thanks for answering all those questions, Dr. Rawls. Thanks everybody for your great questions this evening. I know you enjoyed this, Dr. Rawls. We’ll do it again before long.[01:12:40]
Dr. Rawls: Yep, we’ll do more. I’ve noticed that my screen is very pixelated. And I think it’s the fact that just we’ve had so many people log onto this. So there’s a lot of awareness out there. There are a lot of people that are interested in how to overcome this problem. So we appreciate your patience with the technology. And please come back. There are going to be more webinars, more information.
The way that I found that I can give back is by helping people along in this very difficult process. The more that you know, the more that you can learn about chronic Lyme disease and what it really is. And what you have to do to get well is important. And having been there, I will continue to provide as much information as possible. So I hope to see you again in some future webinars.[01:13:41]
Tim: So some extra resources. One, you can start by watching the previous episode of Ask Dr. Rawls – Lyme Q&A that we did in September. That one has a similar format but completely different questions. So you can learn a whole new set of information there. And that one has got a live transcript and video replay. You can find that at RawlsMD.com. You just search “Ask Dr. Rawls.”
Also, there are a lot of questions about gut health. I recommend you search the “Lyme + Leaky Gut connection.” That would give you great coverage of how gut health is linked to Lyme disease. Also, find that on RawlsMD.com.
And then, we’ve also got people asking, you know, “How can I get involved in my area?” It really can be isolating sometimes. So we’ve created a Lyme Support Directory at RawlsMD.com. You can just type in LymeSupportDirectory. That will redirect you to the RawlsMD website.[The directory is] just tabulations of all the different Lyme groups in the country and other countries as well. And if we don’t have you on there and you’re part of a group, you can add yourself. But it’s a great place for you to reach out for either online or in-person support groups. Check that out.
And then if you’re interested in working with Dr. Rawls one-on-one, he does have consults that you can schedule. And then, he’s also got two wonderful health coaches that he’s trained that help a lot of folks with this kind of stuff as well. They’ve both been through this themselves, just like Dr. Rawls.
So it’s a really great resource for, you know, getting some guidance on how to get started, how to create your approach, maybe troubleshooting some more complex issues, and having someone to talk through this stuff with because we know a lot of people don’t understand what you’re going through. So you can learn more about that at RawlsMD.com/consults.