This week, I have the pleasure of talking to Dr. Evan Hirsch who is an expert on treating fatigue. Having suffered from fatigue himself, he has a great expertise and understanding for the underlying causes of fatigue.
In this podcast, here’s what you’ll learn:
- The most common causes of fatigue (the “Usual Suspects”)
- How chemicals are everywhere and cause fatigue
- What mold does to your body and how to remove it
- How to treat hidden infections like Lyme disease.
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View the interview on youtube here
Treating fatigue by detoxing your environment show notes
How Evan got into functional medicine (3:52)
Evan’s journey to find his field of expertise (6:15)
How Evan passed his exams with an unconventional approach (7:23)
How Evan ended up as a specialist in treating fatigue (8:57)
How he used functional medicine in treating fatigue in himself and his patients (9:48)
What the biggest factors for treating fatigue are (11:51)
What these outside factors are doing to your body (12:56)
What the usual suspects are when first treating fatigue (14:50)
How emotional stress can contribute to fatigue (16:00)
How you can narrow down your own symptoms when treating fatigue (16:42)
Typical symptoms of heavy metal poisoning (17:37)
Typical symptoms of Bartonella (17:59)
Typical symptoms of Babesia (18:14)
Typical symptoms of Chronic Fatigue Syndrome (18:33)
How Evan starts out when treating fatigue in his patients (18:59)
How The Energy Blueprint is structured similarly to the way Evan is treating fatigue (19:40)
How Evan is addressing all possible factors when treating fatigue (20:26)
How to check for hidden infections (21:00)
Common symptoms of Epstein-Barr virus (22:44)
How infections feed off each other and heavy metals (23:24)
How to best address hidden infections when treating fatigue (24:15)
How nutrients are very important for treating fatigue (24:57)
Why Evan always looks at replacing nutrients first when treating fatigue (25:31)
Some of the practical steps for diagnosis and treatment (26:35)
What the difference between clinical diagnosis and testing is (31:25)
Why tests are not 100% accurate (32:26)
What to do when you have a constellation of symptoms (34:00)
Why utilizing glutathione is important for detoxification (35:12)
How infections and chemicals are linked to diseases like Alzheimer’s, Parkinson’s, and diabetes (35:55)
How glutathione and charcoal works in the body (36:41)
How to get rid of the heavy metals in your system (39:16)
Why it takes about a year to remove heavy metals from your body when treating fatigue (39:45)
Why Nano-Zeolite is a good option for heavy metal detoxing (40:58)
What the best brands for gut-based detoxification are (42:58)
Why charcoal is great for treating mold (44:30)
Why detoxing your environment is crucial in treating fatigue (45:55)
Why makeup is a cause of toxins in your body (46:26)
How changing to natural body products can change your sensitivity to chemicals (47:15)
How you should never send a boy to do a man’s job when detoxing (49:15)
How sauna use can help you detoxify your body (50:27)
What the best sauna for detoxification on a cellular level is (52:00)
How the treatment for biotoxins is different from heavy metals (52:49)
Why there is a need to test for mold in both environment and body when treating fatigue (53:19)
What to do to take mold out of the equation when treating fatigue (55:00)
What you can do to treat mold in your home (56:39)
The benefit of using an air purifier for removing mold (57:50)
What some practical tools for removing hidden infections are (58:40)
What hidden infection to go for last (59:37)
How sinus conditions can be yeast, mold, or MARCONS (60:50)
How patients often have co-infections (61:32)
What the practical steps to clearing gut- and blood bugs looks like (61:46)
How cleaning out yeast can help with the sinuses as well (01:03:27)
What to do after addressing yeast (01:04:12)
Parasites can be a problem when treating fatigue, how to treat them (01:04:39)
How to treat sinuses after clearing the yeast and parasites from the body (01:05:04)
How oxygen treatment can be used to treat brain issues like Parkinson’s and dementia (01:06:34)
A warning about treating fatigue and other conditions with ozone gas (01:07:00)
Why professional assistance is important for successful treatment (01:07:30)
How IV ozone is used to treat blood infections (01:10:18)
How cancer cannot live in an oxygenated environment (01:12:00)
How saunas and ozone combined can increase circulation (01:13:26)
How raising your temperature can help treat infections (01:14:00)
Why sleep is important, and how Evan is helping his patients sleep at night (01:15:00)
How infections can keep you awake at night (01:16:40)
Why treating fatigue means going to bed around 10 pm (01:18:46)
Find your exercise tolerance level (01:18:56)
How to get to know more about Evan’s work (01:20:00)
Dr. Hirsch’s new book, Fix Your Fatigue (which I highly recommend)
Ari Whitten: Then we'll be good to go. Everyone, welcome back. This is Ari and I'm here with Dr. Evan Hirsch who is a specialist in treating fatigue. Evan, how are you today?
Dr. Evan Hirsch: I am good, Ari. Thanks for having me on.
Ari Whitten: Cool. So to give all of you a little background about why I'm bringing Evan here it's mainly because my approach has certain limitations and I address things from the lifestyle perspective.
But when you're dealing with this kind of program that you're all in right now where I have this program that's addressing all these different layers of lifestyle factors that can potentially affect your energy levels, one of the issues is it's not bio-individualized.
I don't have diagnostic methods integrated into this where we can actually assess do you have some of the things that we're gonna talk about in this interview like chronic infections or biotoxin issues, or heavy metal toxicities, or things like that. Dr. Hirsch is a specialist in those areas and he knows a heck of a lot more than I do about all that stuff so I wanted to bring him here and talk about his expertise on treating fatigue.
So, Dr. Hirsch, can you just tell us a little bit about your background, what you do, and how you got into it?
How Dr. Hirsch got into functional medicine
Dr. Evan Hirsch: Sure. Yeah, so I ask a lot of questions. While I was growing up I was really interested in science and I just have this passion for helping people. I grew up in New Jersey and so there were no naturopaths, there was really no chiropractors when I was growing up so it was a good fit for me to plan and go to medical school. I went to undergrad, went to medical school, and when I got into medical school once again, I had a lot of questions. I always want to understand things, I don't want to memorize things.
Professors that I had they were great, but they just didn't really answer my questions to the fullest degree. So I had to start doing research and had to start asking more questions, thinking about the power of the mind, power of the body, what's going on really at the most basic level.
I went and the first training that I did was a clinical hypnotherapy training when I was a second-year medical student. Then I met there some holistic medical doctors and they said, "Hey, you should come join our group." So I went to American Holistic Medical Association meetings, and that was just amazing. They were talking all about how magnesium can reverse migraines, like all these nutrients, nutritional therapy stuff, which was just wonderful.
Ari Whitten: This was already while you were in medical school?
Dr. Evan Hirsch: Right.
Ari Whitten: Oh, wow. You're getting an early start. Just to point this out to people, he was in school to become and M.D., and he's, at the same time, doing all of this holistic stuff. That's very, very unusual.
Dr. Evan Hirsch: It is, yeah. But I thought that I was really the only person of my kind. In my fourth year, we were able to do electives and I found this elective at Bastyr, which they called cam camp. So a couple of alternative medicine camp and it was a month long rotation for allopathic and osteopathic students with their faculties.
We went to and we stayed at Bastyr, which was just a wonderful experience. We had a chance to know a lot of naturopaths, and we've learned all about nutrition and homeopathy and herbs and it just kind of blew my doors off.
Then I met, for the first time, other medical students who were like me. That was just, it was just amazing when you find your community of people who you jive with.
Evan’s journey to find his field of expertise
Ari Whitten: Yeah, for sure. How is that ... So you graduated medical school and then you went on to go to your residency and what did you do your residency in?
Dr. Evan Hirsch: I was all set to do a psychiatry residency. Then I decided to change my mind, I decided to take a year of between medical school and residency. I went and I got my yoga teacher training at Kripalu in Western Massachusetts. I went and I did a medical acupuncture training for physicians through UCLA, the Helms program.
I did some travel, went to Australia and Alaska, all that [inaudible] stuff while I was doing other rotations, too.
Just once again just asking these questions, what does health look like from a number of different paradigms? How can I support people?
At this point, I was really thinking mostly about integrative medicine and holistic medicine. So kind of this idea of ”oh, you have high blood pressure,” I'm gonna use acupuncture, yoga, and magnesium instead of a conventional medication.
How Evan passed his exams with an unconventional approach
Then I went into residency in Olympia, Washington and my residency was great. They, as soon as I've proved myself an allopathic medicine ...
Oh, and I decided, so I decided to go into family medicine. I changed my mind. I just had to go into family medicine because I wanted to really address the whole person. I did the family practice program here in Olympia to University of Washington program, they've got a division in Olympia. The people were really great.
Once I proved myself an allopathic medicine they really allowed me to do more integrative medicine. They just said, "Well, why did you do this," when they were reviewing my charts and I would send them the data, the research. They would say, "Okay, that looks good." They even allowed me to do acupuncture so I was doing acupuncture on the medical exam table.
It wasn't super comfortable for my patients, but it was kind of, you know, whether it was covered or not we were in a low-income clinic and so some of these people who didn't have access to this stuff were able to get access.
Ari Whitten: That's awesome, so you were actually ... Was this during your residency that you were able to do some of this stuff?
Dr. Evan Hirsch: Yeah, mainly my third year.
Ari Whitten: Wow, that's awesome. So you kind of played their game. They were skeptical of some of the alternative stuff and you said, "All right. Well, I'm actually gonna show you the scientific literature that says that this stuff works and you're gonna have to accept that since there's science on it that this is okay. That's awesome.
Dr. Evan Hirsch: Yeah. They couldn't really argue with it when I showed them the data.
How Evan ended up as a specialist in treating fatigue
Ari Whitten: Cool. So how did this ... So take me on the journey, the next steps. How did you end up, from there, as a fatigue specialist?
Dr. Evan Hirsch: Let's see, around this time ... Well, actually around 2004 when I entered residency, I met my wife. She was vibrant, full of joy, very social. Then right after we got together she ended up starting to feel ill. She ended up getting fatigue for about three years. I was totally powerless.
I was studying with Jonathan Red and doing this stuff in residency and I couldn't help her. She had done a bunch of research on her own, asked a naturopath locally for adrenal saliva index, and her adrenal glands were totally bombed out. I was with her through all those challenges and it just left ... It was just really hard.
Then I came out of residency and the first training that I did out of residency was in functional medicine, in the Institute of Functional Medicine. That was really big. I'd heard about it for a couple years previously when I went for my board certification in holistic medicine and a couple of other training.
I came out and I found functional medicine, it totally jived with me. It was all about getting at the cause, which I tell people I practice Causology medicine. Like what is the root cause or root cause medicine, that's the most important thing to me as it helps me treating fatigue in my patients.
Let's get down to the roots and let's figure out what's causing this because then you can remove that cause and then people can get better as we start treating their fatigue.
How he used functional medicine in treating fatigue with himself and his patients
So it came out of residency, did this training, started my practice, and very soon thereafter, I got fatigue.
Ari Whitten: Oh, wow.
Dr. Evan Hirsch: Yeah. Then I had fatigue for about five years, while I was treating fatigue in my patients. Functional medicine is just amazing for lending itself to treating fatigue, so the people that were coming in I just started seeing a lot of fatigue. As I was learning more about treating fatigue on patients, by practicing on myself, I was putting together basically all of the best practices that I found of these different experts, what now I call my ”Fix Your Fatigue Program.”
It took me about a decade to really get rid of my own fatigue. I helped about a thousand people in my own practice, resolved their chronic fatigue.
So now I'm like I have the energy, I have more patients that I know what to do with, and I really want to help all of them, but I can't because I'm limited by time and a one-on-one session. So I want to create, I want to help ... My goal now, is treating fatigue in a hundred thousand people resolve their chronic fatigue.
Ari Whitten: Awesome. I love that. Very cool. So let's get right into it. So what are ... In your practice ... How long have you been in practice, by the way?
Dr. Evan Hirsch: Almost a decade, nine years.
What the biggest factors for treating fatigue are
Ari Whitten: Awesome. In those nine or 10 years that you've been in practice what have been the biggest factors that are causing people's fatigue, lack of energy? Maybe you can talk a little bit, too, about the difference between your approach versus the typical allopathic, conventional, M.D. approach.
Dr. Evan Hirsch: Sure. So, there are things that we come into contact with in this world that aren't supposed to be in our bodies. So those are heavy metals, that's lead and mercury and arsenic and cadmium, stuff like that.
Chemicals, you know, there's 84,000 chemicals that we're exposed to every ... That are dumped into the system every year and a lot of our products and what-not, and only 10% of those have been tested.
Molds, so mold is a huge problem. About 50% of all buildings in this country have water damage, and we don't know which 50% of those are. Mold is a known neurotoxin and causes a number of problems.
Then infections, so Epstein-Barr, Lyme, mycoplasma, Yersinia. So there's a number of these different infections.
What these outside factors are doing to your body
Those are all the things that can cause fatigue from an exogenous or an outside source. What ends up happening is that causes deficiencies on the inside. So, the stress of all those things will cause hormone deficiencies. Your adrenals will be taxed, which is a little triangular gland that sits on top of the kidneys that's responsible for producing your ”get up and go” and manages insulin. I mean, you talk a lot about this in your class, which is really awesome. Sex hormones, thyroid hormones.
The stress of this as well as all of those things that I call the usual suspects, which are heavy metals, chemicals, molds, and infections, all of those usual suspects will also cause autoimmunity.
So they'll get hidden in the thyroid, the immune system will try to get rid of it and has to get through the thyroid to get there. It starts damaging the thyroid and causing autoimmune thyroid disease.
Ari Whitten: Then once you start damaging the thyroid gland, now you have hypothyroidism and a whole new set of problems that results from the hormonal issues of that whole set of problems and you now have more steps to take in treating fatigue.
Dr. Evan Hirsch: Absolutely. There's a beautiful dance with the hormones where the thyroid, the adrenals, and the testicles in men, ovaries in women, all have to be in concert - just like a beautiful symphony. If somebody steps out of that dance, it leaves the other two holding the bag.
Oftentimes, when somebody comes in and they're like ”I know I've got adrenal problems,” and we look, and sure enough they've got adrenal problems, but they also have thyroid ... Oftentimes, you can improve the thyroid function by boosting the adrenals and vice versa.
What the usual suspects when first treating fatigue are
Ari Whitten: The usual suspects are metals, hidden infections, chronic infections, and biotoxin, mainly mold. Is that correct? Did I miss one or those are [crosstalk]?
Dr. Evan Hirsch: Chemicals.
Ari Whitten: Chemicals, that's right.
Dr. Evan Hirsch: Well, yeah. And biotoxins I would put heavy metals, chemicals, and mold and actually all of them are biotoxin owners. We have some markers that will detect them generically and then some that are more specific at determining which is the cause. Usually, people have multiple causes.
It's the number of hits that it takes that people get throughout time, the number of stressors.
So whether it's being exposed to mercury ... I got exposed to mercury by having mercury fillings and by eating a whole bunch of tuna fish growing up. I ate it every other day, probably from most of my childhood. We didn't know that tuna had all of that mercury back then.
So chemicals, all the chemicals that we're exposed to.
How emotional stress can contribute to fatigue
It's all these hits that we get plus emotional and mental hits. So for me, it was going through residency, going to medical school. Emotional, like a breakup, and of course, there are car accidents.
So anything that's stressful just kind of, they will end up causing dysfunction in your hormones, dysfunction in the immune system, and then the infections can take hold. So it's kind of this, I call the imperfect storm where there are all of these things acting at the same time, and all of them are feeding off of each other, and they result in the chronic fatigue picture.
How you can narrow down your own symptoms when treating fatigue
Ari Whitten: Got you. So how can someone know if they have some of these problems? Is there a certain set of symptoms that might hint that this is coming from a chronic infection or coming from heavy metals? Are there certain tests like blood tests or stool tests that people can start to go to start identifying this when they start treating fatigue? I guess, let me summarize my question as, now that we know that these factors can impact our fatigue or energy levels, what do we ... How do we start going about identifying if these are factors for us and figuring out which ones are, maybe which ones aren't?
Dr. Evan Hirsch: Absolutely. So we have a 17-page initial questionnaire. There are a lot of questions to ask around this, and you know, the symptoms that you're looking at can be congruent or can be similar, depending on the cause but helps treating fatigue with the individual patient.
Typical symptoms of heavy metal poisoning
So if somebody's got heavy metals or if they got mercury toxicity they can have brain fog, fatigue, and neuropathies. But they can also have that if they have Lyme or if they have Epstein-Barr or if they have mold.
Typical symptoms of Bartonella
There are some which are a little bit more specific. Like for example, if you have pain or discomfort on the bottom of your feet and you have occasional headaches, weird stretch marks, some vascular diseases, you probably have Bartonella, which is a co-infection of Lyme.
Typical symptoms of Babesia
There's some of these that are more specific. Another example is Babesia where people will have shortness of breath, they'll have depression and anxiety so bad that it even could lead to suicidal thoughts, and sweating like you're sweating all the time, you don't know why you're sweating. That's caused by Babesia.
Typical symptoms of Chronic Fatigue Syndrome
So some of those are a little bit more specific, but generally, the people who have chronic fatigue syndrome, which is basically six months of four of these symptoms of enlarged lymph nodes, muscle pain, fatigue, brain fog.
That's a bit of an oversimplification and you're not ... All of these diagnoses are kind of a conglomeration of symptoms and they're not getting at ... They're not differentiating and they're not getting at the cause when treating fatigue in their patients.
How Evan starts out when treating fatigue on his patients
One thing I found was that I had to go for the broadest differential I possibly could if I was going to catch everybody who came into my practice. So I need to say, okay, so fatigue can be caused by five things, that's great. But if I find out a sixth thing or seventh thing or 20 things I need to make sure that I'm addressing all 20 of these things when somebody walks in to make sure that I get at treating fatigue. Because if I'm addressing 19 things and the 20th thing is the major thing, I'm gonna miss it.
How The Energy Blueprint is structured similarly to the way Evan is treating fatigue
Ari Whitten: Yeah. I totally agree with that, and my program is designed around that as well. For some people, circadian rhythm and sleep may not be a huge factor. For other people, it is a huge factor. But everybody is going to benefit at least a small amount, if not a huge amount from addressing those habits around circadian rhythm and sleep, just as one example.
I think you're really saying the same thing. It's like we have all these potential causes. The symptoms are diffused and not always easy to say, "This symptom is a direct result of only this one factor." So you want to address as many of the factors as possible. Is that where you're going?
Dr. Evan Hirsch: Absolutely.
Ari Whitten: Cool.
How Evan is addressing all possible factors when treating fatigue
Dr. Evan Hirsch: The great way of thinking about this is that when a patient comes into my office they have like 16 nails in their foot. I can take out the gluten nail and they can go off gluten and they may experience a 1% increase or nothing because maybe it's the mold nail that has to come up. Once I remove that mold nail, that all of a sudden that gluten nail becomes that much more important. We got to remove all the nails. You got to make sure their sleep is good. I mean that's number one. You know all about that. Make sure their circadian rhythm is good. We got to remove all of those nails in order for them to really achieve the best help of their lives.
How to check for hidden infections
Ari Whitten: Cool. Yeah, and by the way, that's really why I brought you here is because I realize that there were some nails that I was missing as around specifically hidden infections, metals, and biotoxins, and addressing some of these other environmental chemicals. So yeah, you're taking care of some of these other nails here. Are there any specific symptoms that will suggest to somebody ... You know, obviously, fatigue, in general, is a very diffused symptom. It can be caused by so many dozens of different factors that fatigue, by itself, doesn't really tell us a whole lot about the causes.
It's sort of like fever. If you have a fever it could be caused by a million different things, some are very simple like a common cold, others might be life-threatening. So are there maybe a handful of symptoms? I know you mentioned swollen lymph nodes. Are there any other specific symptoms that might suggest a hidden infection as opposed to, let's say, a metal toxicity or chemicals, for example?
Dr. Evan Hirsch: Uhmm...
Ari Whitten: Or is it still too vague?
Common symptoms of Lyme disease
Dr. Evan Hirsch: Yeah. Unfortunately, it's too vague. Usually, everything has to ... Unless something is screaming, you know, if somebody's got Lyme disease they're gonna have migratory arthralgias. So they're basically gonna have joint pain that migrates around the body, where one day they wake up and this joint hurts. Next day they wake up, the other joint hurts. You can't really have anything else except for Lyme with those symptoms.
Common symptoms of Epstein-Barr virus
Epstein-Barr's gonna give you enlarged lymph nodes, it's gonna give you mood issues, depression, anxiety, it's gonna give you the fatigue and the brain fog. But the enlarged lymph nodes oftentimes it's Epstein-Barr, though it can also be Bartonella, which is otherwise known as cat scratch. If you have a cat scratch in a certain area and you get an enlarged lymph node at that proximal area, so basically closer to the heart then that could be that particular infection. I spoke a little bit about Bartonella, spoke a little bit about Babesia as some of those specific symptoms.
How infections feed off each other and heavy metals
But oftentimes it's hard, and it's also, you know, they also feed off of each other. So, infections will feed off of heavy metals and chemicals.
Oftentimes we have to get rid of heavy metals and chemicals first in order to go after the infections. Or mold is hijacking the immune system so the immune system can't deal at all with Lyme and these other infections. There's actually some studies to indicate that if you treat molds sometimes Lyme goes away, and if you treat Lyme sometimes mold goes away. So it's this hodgepodge and they're all having this effect on the immune system. The immune system, they are all hijacking the immune system.
Ari Whitten: They're like overwhelming the immune system such that it can't really do, it can’t really count enough of a response to actually take care of say, the hidden infection if it's being bombarded with mold and chemicals and heavy metals and things of that nature?
Dr. Evan Hirsch: Yep.
How to best address hidden infections when treating fatigue
Ari Whitten: Got you. So do you recommend that pretty much everybody who's suffering from fatigue who comes into your office, do you recommend that they try to address hidden infections as sort of removing that nail and do some treatments to address that?
Dr. Evan Hirsch: It really depends. So you know, there is this spectrum so like you're talking about with your course, you're getting people who have fatigue who can be remedied with sleep and circadian rhythm and I've got about through half of your course. I don't know everything yet, but I think you get into mitochondrial function and some of this other stuff.
How nutrients are very important for treating fatigue
Then the next step is nutritional deficiency so I didn't talk about that yet. But nutritional deficiency we talked about like hormonal deficiencies, but nutritional deficiency is oftentimes can heal a lot of stuff and can be great at treatig fatigue. B12 deficiency, vitamin D deficiency, other B vitamins. There's a number of them that we do a NutrEval test, which is wonderful for looking at all of the potential nutrient deficiencies, magnesium and molybdenum, and all these sorts of stuff.
Why Evan always look at replacing nutrients first when treating fatigue
I will first start with replacing what's deficient. I always like to make people strong first, because if we're gonna go after the usual suspects you have to be strong in order to be able to do it. Because there's die off with these infections. Your adrenals have to be good, your thyroid has to be good, all of your nutrients have to be replaced in order to be able to go through the process as gracefully as possible.
That's really my goal, is to help people get better, faster, and safer.
There's a lot of Lyme doctors out there who are doing really good work, but when you really focus just on the Lyme and you're hitting them with you know, antibiotics or antimicrobials or whatever it is, and you're not supporting the adrenals, you're not supporting the nutrient deficiencies you end up picking up the pieces at the end.
So basically it may take you another year of treating fatiue causes, just to boost them back up to where they need to be. So what I like to do when I find that this is really successful is to keep them strong. So replacing those nutrient deficiencies, replacing the hormones, and then going after the usual suspects.
Some of the practical steps for diagnosis and treatment
Ari Whitten: Nice. Okay, so take me through I guess, what you would ... Let me put it this way. Let's say I come to you and I'm struggling with fatigue. You tell me everything you just told me, and I start to go you know, "I feel like I got some swollen lymph nodes, I've had some of these other symptoms that you've mentioned. How can I start figuring out which of these factors apply to me and how can I start addressing them?" Can you take me through a little bit of some of the more practical steps as far as diagnosis and treatment?
Dr. Evan Hirsch: Absolutely. So I would start off by doing some labs. So we work with a company called True Health Diagnostics for our blood testing, which looks at cholesterol and inflammatory markers, and blood sugars, and nutrient deficiencies. This is all in blood.
Then we look at Genova's NutrEval, test to look at nutrient deficiencies and also some really good mitochondrial markers, stress markers on a mitochondrion, which is the energy center of the cell that can be damaged by all of the usual suspects. I just learned recently at a conference that mitochondria are also a modulator in its own right, so it modulates the immune system. It actually can improve thyroid function by modulating the enzymes that allow thyroid to get into the cells. So we're learning all these wonderful stuff that's coming out right now.
That's the True Health and the NutrEval. Then to look at infections I will look at Medical Diagnostics Laboratory. They do a really good job at looking at serology so basically immune system reactivity to infections.
There are other labs that might be better, but they're a lot more expensive, and the Medical Diagnostics Lab does a really nice job for the price and it gives us a lot of really good, useful information that we can use in order to help the patient.
Ari Whitten: Real quick to interrupt you. Are these diagnostics that people who are listening right now can go and do on their own so they can start treating fatigue in themselves?
Dr. Evan Hirsch: So the way that they would be able to do those would be to go to directlabs.com. That's kind of like a third party that has a physician attached to it that allows people to purchase them.
Ari Whitten: Okay. And the ones they would want are the NutrEval, the Health Pro, was it?
Dr. Evan Hirsch: The True Health Diagnostics I'm not sure that they can get through there. You will probably have to go through your local lab for that. You just need somebody to write the order for that.
The Medical Diagnostics Lab maybe on that, I'm not entirely sure. I'm not sure what they have for infection testing at least in blood. But the NutrEval test I'm pretty sure that they have and that's by Genova.
Ari Whitten: Okay. So is there a way for people listening to get a test for say, hidden infections or heavy metals, for example?
Dr. Evan Hirsch: Yes. So for the heavy metal test, I recommend using Doctor's Data Test. The Doctor's Data you have to do it before and after Provocation Challenge Test. So the before is basically you wake up in the morning and you urinate and that tells you what's floating around in your bloodstream. Then you take a chelation agent, which oftentimes is DMSA or DMPS or even, in some cases, zeolite. Then you collect your urine for the next six hours so that's the second kit. That's going to pull out the heavy metals from the tissues and give you a tissue burden analysis, that's going to ...
You're gonna see this really significant increase if people have significant heavy metals in the tissues because that's where they like to live. You're not gonna see the heavy metals floating around in the bloodstream. You're gonna see it in the tissues so you have to do this challenge test, and that one is on that Direct Labs website.
Ari Whitten: Okay.
Dr. Evan Hirsch: Now, in terms of the infections I'm not sure that you can gather that so for folks as I take them through my program virtually, so I'm creating an online platform, online courses, to take people through this, hold their hands and whatnot, we're gonna be using mostly clinical diagnosis, which the Center for Disease Control says is appropriate in Lyme and Lyme co-infections because those are more specific. It's easier to do that with a lot of those. Some of those infections are easier to do clinically and you don't necessarily have to do the testing.
What the difference between clinical diagnosis and testing is
Ari Whitten: Got you. Okay, so explain a little bit more about what that means. What does it mean to do it clinically versus via testing?
Dr. Evan Hirsch: Sure. So, a clinical diagnosis is a diagnosis made by the physician based off of your signs and symptoms. So basically the questions that I ask you, your responses to that, and then the exam that I do on you. That's the gist of it.
Ari Whitten: Okay. Is that something you're gonna do in your courses while you're gonna walk people through a process?
For people who might suspect that hidden infections are a problem for them, how can they, I guess, start to go about addressing that on their own? Is there any way where they can figure out how to diagnose or treat themselves, treating fatigue?
Dr. Evan Hirsch: Yeah. One of the things that I am going to do through the course is I'm going to discuss if you have these symptoms. So I'm gonna do it based off of symptoms or what I do in my clinic with my patients, and not necessarily off of the signs because I'm not doing a physical exam on people.
Why tests are not 100% accurate
But the thing to remember too is that these tests are not a hundred percent. They are highly imperfect. So the infection test that we're doing is a serology test, it's looking at the immune system's reactivity to a certain infection.
If your immune system has been hijacked by one of the usual suspects, all bets are on. One of the things that we see is that people will come in, and they'll show no infections and I'm like, "I know you got infections." We start removing the usual suspects and all of a sudden as the immune system starts to come back online we repeat the test and all of a sudden there's a positive test for the infection that I thought that they had.
Ari Whitten: Interesting. Doing the diagnostic test are not necessarily that needed, they're not that critical. It's more if you have some of these symptoms it doesn't hurt to start removing those nails just as with the hunch that they probably are there in some form or another.
Dr. Evan Hirsch: Absolutely. You know, we like to test because it helps for the clinician. You know, we say, "Don't guess. Test." It helps for the patient who comes to start treating fatigue so they can actually see they can get some sort of definitive tool instead of taking my opinion like, "Yeah, you've got these symptoms, you've got this infection. Let's treat it and you're gonna spend this much money and spend this much time going after this infection.
As humans, we just like to see that data, even though that data may not be perfect. It's still as reassuring that we're well on the right path.
What to do when you have a constellation of symptoms
Ari Whitten: Got you. Let's say someone has some constellation of these things, and I know you had said it's usually not just one, it's a combination of sort of all of the usual suspects or at least several of them. What does it look like as far as starting to address these factors, starting to pull some of these nails out?
Dr. Evan Hirsch: Yeah. So we always like to go with the low hanging fruit first. Now, this is after we replace all of the nutrient and hormonal deficiencies. Once you have the person stronger ... So people come in and they say their energy as like a two out of 10, with 10 being ideal energy, generally, as we start to replace all the nutrient deficiencies or the hormonal deficiencies, we can get them up to five or six out of 10. Oftentimes they're able to go back to work. Some people that can get them all the way up to eight out of 10, it really depends on what's going on. Then we go into the usual suspects and I like to get rid of heavy metals and chemicals first and set up good detoxification pathways.
Why utilizing glutathione is important for detoxification
So utilizing glutathione, which is the body's main antioxidant and detoxifier, utilizing different binders so zeolite or charcoal, from a more natural perspective. Then going after the infections. Sometimes people are really chemically sensitive, they come in, they can't tolerate much of anything that I'm giving them. Some because of the infections that are present sometimes I have to go after the infections right away otherwise we're not gonna get anything done. But ideally with this process of removing, as I say, the crap off of your immune system and we're just taking layers of it off.
How infections and chemicals are linked to diseases like Alzheimer’s, Parkinson’s, and diabetes
While we're treating fatigue causes, we're also preventing stuff for the future, not only are you gonna feel better now, but it helps prevent Alzheimer's. Seven out of 10 Alzheimer's brains in one study, had Lyme in it. It's gonna prevent Parkinson's. There's more and more research coming out about chemicals and Parkinson's and chemicals and diabetes.
Pesticides are very quickly becoming a major cause of diabetes in this country.
Ari Whitten: Yeah.
Dr. Evan Hirsch: As much as we can remove off of the immune system, off of the liver, off of the nervous system, the body just, it goes through some uncomfortable periods, but it just keeps on getting better and better and better.
Ari Whitten: Got you. So you mentioned charcoal, zeolite and I think there was one other one in there used for treating fatigue.
How glutathione and charcoal works in the body
Dr. Evan Hirsch: Glutathione.
Ari Whitten: Glutathione, that's right. What are these compounds? Can you talk a little bit about what they're actually doing in the body? I know glutathione is involved in detoxification, it's an antioxidant. What are some of these other things doing and do they detoxify sort of everything universally? Do they get a mold toxin or is it more chemicals? What are your preferences on sort of how to use those different substances?
Dr. Evan Hirsch: Absolutely. The way that I explain glutathione is that it's opening up the pathways in the liver. So, as we're going through this process if you are binding up and trying to remove things, but you can't get it out of the liver you're gonna feel worse. So we have to open up those pathways. Glutathione is great for doing that. Taking your B vitamins, B12 and folate will bypass MTHFR and some other genetic snps, genetic issues that you may have in terms of detoxing through methylation, which is phase two of detoxification.
We'll just take a step back here. So phase one detoxification, you want to make sure that you're eating a really clean diet. You want to make sure you're getting enough amino acids for this process, getting enough leafy greens.
Then phase two you're getting more into methylation and then transsulfuration. Methylation is B vitamins which will decrease homocysteine levels, it's another great marker that we look at for improving methylation and detoxification function. Then in transsulfuration, the main product is the glutathione.
So that's just kind of a brief overview about detoxification. Then phase three is elimination. So it's getting it out of the stool, out of the urine. If you can't get something out of the liver, if you can't get it out of the urine, if you can't get it out of the stool, it's gonna come out of the skin so when people start to get rashes, when they start to sweat more.
Oftentimes we will use saunas as another means of getting things out. Coffee enemas are great because they will cause the liver to start to dump the whole bunch of stuff. There's essiac tea, it's great for liver detoxification and has also been shown to be helpful in cancer therapy.
There's a number of tools that we will use in order to improve those detoxification pathways. So number one, detox.
Ari Whitten: Okay.
Dr. Evan Hirsch: Go ahead. Did you have a question?
Ari Whitten: Yeah, no. You were gonna take us through something there so I was kind of interrupting you. Go ahead.
How to get rid of the heavy metals in your system
Dr. Evan Hirsch: It's okay. So number two is these heavy metals. I've used a number of different things over the years in order to get rid of heavy metals. I like to do things safely so I don't do rotational chelation. I like to do slow, steady chelation at a lower rate. I like to take about a year to get people's heavy metals out.
Ari Whitten: Oh, wow.
Why it takes about a year to remove heavy metals from your body when treating fatigue
Dr. Evan Hirsch: Just because I've seen that when you go hard and heavy that you get- not only does it bind up your minerals, which can cause other problems, but you can also get redeposition. Now what this means is that, like we talked about, heavy metals are in the tissue, you start to pull it out and you pull it out of the tissue it goes into the blood and then if it's not bound up appropriately, there's too much coming out at the time, guess what? It goes right back into another place and if somebody's got brain fog and you start to chelate them and all of a sudden they're getting more brain fog because you've just redeposited into the brain. It doesn't feel good as a clinician, it doesn't feel good as a patient, so in this case, slow and steady wins the race. I like to use things like zeolite or things like lipoic acid. Those work really great. What's that?
Ari Whitten: Alpha-lipoic acid?
Dr. Evan Hirsch: Yep, alpha-lipoic acid is a natural chelator in its own right. Not only does it boost the mitochondria, but it also chelates naturally.
Why Nano-Zeolite is a good option for heavy metal detoxing
Ari Whitten: Okay. A couple of questions on details here. One, I listened to an interview recently with a guy named Dr. Pompa, Vincent Pompa, I think was his name? He promotes some product that is a zeolite-based product that he says I think that the selling point on it was that it was micronized and it was smaller molecules that can actually get into the cells. He was drawing this distinction between detoxifying at the blood level or in the gut versus actually getting into across the cellular membranes, across the mitochondrial membranes and being able to detox on that level.
Have you read anything on that or have any insights into detoxing at the cellular level as opposed to the gut or the blood?
Dr. Evan Hirsch: Absolutely, yeah. I like to use a nano-zeolite, which is very similar. You always want to ... If you got some data to see if it works that would be great. I've seen this product, they've done some case studies before and after urine like we talked about with doctor's data, and they found in one patient a 5,400 increase excretion of mercury utilizing this particular product. Then a thousand increase excretion of lead, and 500% increase in some other and cadmium or arsenite, or something like that.
So you want to see some data with these products. I'm not familiar with that product, it might be the hydrolyzed zeolite that I think I've heard about that I'm very interested in looking into because I've heard good things with some colleagues of mine that I respect a lot.
So yes, generally the zeolites will stay just in the gut along with bentonite clay and stuff like that, and they may pull a little bit out of the tissues. You'll still get some, but you're looking at probably five years of detoxification instead of a year or so. Utilizing something that can get up to cellular level is definitely advised.
What the best brands for gut-based detoxification are
Ari Whitten: Got you. Okay. Would you recommend doing some of the gut-based detoxification? Like I assume charcoal is more gut-based, bentonite clay mostly stays in the gut. What we're really talking about is it sounds like a combination of stuff that acts more on the gut and the blood versus in the cells as well. I guess the nano zeolites are mainly what ... Is that the main thing that's actually gonna get into the cells and detoxify in that level?
Dr. Evan Hirsch: Correct. At least what I use.
Ari Whitten: Okay. Do you have a specific brand recommendation on that or ... Actually, one thing I've read on zeolites is some of them are contaminated with lead and do you have a good source for a one that maybe is not contaminated and has these case studies to support it as well?
Dr. Evan Hirsch: Absolutely, yeah. I like the Results RNA products. People can get those from my website if they're interested in going there. It's fixyourfatigue.org, you can click on the shop and create an account, and purchase that stuff. A lot of these products are practitioner only products so you can only get them from providers. That would be a good one to get. There's also free shipping and stuff like that on there, too. The alpha lipoic acid brand is Biotech. There's really only two brands that are recommended, Biotech and Metabolic Maintenance, and that's on there as well.
Why charcoal is great for treating mold
Then I don't think I answered the question on charcoal. Then charcoal I use for molds so it's great for binding up mold spores and mycotoxins. So the concern with molds is that you can get ... Mold spores are like 0.3 microns in terms of their size, but mycotoxins are down to 0.003 microns so they're just very small, very hard to get rid of them. So there's a number of other things that you kind of need to do when you're going after mold, but charcoal and glutathione are really main stage treatments.
Ari Whitten: Got you. Is charcoal mainly acting in the gut? I mean it's obviously you ingest it and at that point do those compounds stay in your gut or do some cross the gut membranes and act in the blood as well?
Dr. Evan Hirsch: Correct, they do get into the blood.
Ari Whitten: Okay, interesting. So compounds from the charcoal itself are now acting in the blood and working to bind things up in there.
Dr. Evan Hirsch: That is my understanding. I mean we do see systemic improvement, you know when people are getting improvement in their symptoms when they're taking it. So, I have to believe that that's happening.
Ari Whitten: Got you, okay. Charcoal, zeolite, and there was one other one. We have glutathione and alpha lipoic acid. Anything else worth mentioning there?
Why detoxing your environment is crucial in treating fatigue
Dr. Evan Hirsch: I'm trying to come back to the original question. I'm trying to remember what it was.
Ari Whitten: Yes, detoxifying metals and biotoxins, chemicals.
Dr. Evan Hirsch: Got you, so we were doing the heavy metals, the chemicals. The nice thing about zeolite is that it's gonna get heavy metals and chemicals. Now, all this is not if you haven't changed your environment. So if you're still being exposed on a regular basis to molds, if you're still being exposed from your cosmetics you know.
Why makeup is a cause of toxins in your body
Unfortunately, there's just so many products out there that are constantly exposing us to stuff that we have to just really become mindful about it. For women, I require all of my patients or ask all of my patients to go to I think it's skindeep.org from the Environmental Working Group.
If they can put in their cosmetics and it'll tell you what the toxicity of that is. There was some study that came out I think about a year ago that looked at lipsticks, and about 70 to 80% of all lipsticks on the market had a significant dose of lead.
So it's really important to get all of your products verified through that website and then you can look at ... They also have, you can look at which ones are ranked the best so have zero or one toxicity as opposed to 10 toxicity so you can go and then you can purchase those products.
How changing to natural body products can change your sensitivity to chemicals
Ari Whitten: Yeah, interesting. Let me ask you a question. I just had a thought in my head as you were talking. When I transitioned from typical American boy using all the standard like shampoos and conditioners and skincare products and things like that, and when I started to become more health conscious and more aware of all these different chemicals and stuff like that, and transitioned to all very natural methods of washing my hair, brushing my teeth, cleaning my skin, washing myself in the shower, and really paid attention to using only very natural stuff, I noticed that I became much more sensitive to chemicals.
Like when people walk by me who are covered in perfume or shampoos and stuff it like overwhelms me to just to smell them. Not that I like having negative symptoms from it, it just blows my mind that people are dousing themselves with so many different chemicals all the time. Do you find that that's common, that as people get this stuff out that they become much more sensitized and aware of all these different chemicals in their environment?
Dr. Evan Hirsch: Absolutely. It's the challenge of clean living, what our ... Yeah, this is just incredibly common. The question is why does that happen? Maybe it's because there's toxicity that you're removing from your olfactory bulb that causes you to ... Your smell will be more sensitive. But it seems like you know, as we get more and more bogged down with all these usual suspects, our body kind of turns down the volume so that we are not affected so significantly. Then when you start living clean the body's like, "Oh, good. Everything's working better and now I can react more with my environment," and now you get more signals about what's toxic and what's not.
Ari Whitten: Got you, interesting. Yeah, I was wondering about that.
Dr. Evan Hirsch: That's my theory.
How you should never send a boy to do a man’s job when detoxing
Ari Whitten: Yeah, that makes sense. A couple of more questions on detoxification. So one is cilantro and chlorella. I've heard something to the effect of ... I'm trying to remember the terminology that was used, but it's like partial binders versus complete binders, something to that effect, talking about how these things may bind but they don't effectively remove it from your body. Do you know anything about that? Are cilantro and chlorella effective means of detoxifying heavy metals or are they kind of not so effective?
Dr. Evan Hirsch: Well, when I was going to school in Ohio for undergrad we used to play [inaudible] which is like a hard scammer, it's a trump game. It was a strategy there, don't send a boy to do a man's job. Where if you want to get the job done right it's got to be strong enough. So with cilantro and chlorella, it's kind of like yeah, you can get rid of your heavy metals and chemicals, it'll just take you five or 10 years to doing it. You can do it more potently, but as safely that's always the goal.
How sauna use can help you detoxify your body
Ari Whitten: Got you. Okay. Then one last question on detoxification. What do you think of using a sauna in conjunction with niacin? I've heard something to be effective that using niacin prior to getting in the sauna may help more effectively remove the toxins.
Dr. Evan Hirsch: Yeah, so a lot of our toxins are stored in our fat cells, which is why a lot of people can't lose weight, it's because the body's protecting us actually. So what ends up happening is that the toxins get into the fat cells and they're to protect us the fat cells get bigger. The way we gain weight is either with bigger fat cells or more fat cells. When you start treating fatigue and start to remove the heavy metals and chemicals and toxins and whatnot, those fat cells will start to shrink, people oftentimes will lose weight.
The same thing ... It's similar when you're doing that with the niacin. Using immediate acting niacin will cause those fat cells to explode or basically to lyze and open up and kind of leak their contents out so that you can bind them up. Or you can get them out utilizing the sauna.
If you're gonna do the immediate acting niacin I do recommend that you combine that with utilizing a zeolite or charcoal or modified citrus [inaudible] and something like that after the sauna.
Ari Whitten: That's because niacin is opening things up and releasing these toxins, but then you want to introduce something to help actually clean them up and get them out of your body?
Dr. Evan Hirsch: Absolutely.
Ari Whitten: Okay. Cool. Good stuff on detoxification. Let's go into ...
What the best sauna for detoxification on a cellular level is
Dr. Evan Hirsch: One more thing. One note on sauna. I do recommend a far infrared sauna for treating fatigue because it detoxes at the cellular level, but any sauna that causes you to sweat is gonna be good. I have some patients who come in who can only do five minutes in the sauna, then we just increase slowly. It's a wonderful detox support. All of us should really have saunas in our backyards just like a lot of European countries do.
Ari Whitten: I actually just before I got on the call with you I was just in my far infrared sauna.
Dr. Evan Hirsch: Nice. Awesome.
How the treatment for biotoxins is different from heavy metals
Ari Whitten: Yeah. So we talked about detoxification, getting rid of heavy metals, biotoxins, things of that nature. Biotoxins kind of wrapped up in that, the same things that will detoxify heavy metals will also get biotoxins, is that right?
Dr. Evan Hirsch: Not exactly, so biotoxins can be mold, Lyme, or heavy metals, so the mold treatment is gonna be a little bit different, and the Lyme treatment is gonna be a little bit different in what we discussed. Then we’re mainly, we’re discussing heavy metals and chemicals.
Ari Whitten: Okay, gotcha. So is there any more specifics that we should get into around biotoxins? Or is that really just ...
Why there is a need to test for mold in both environment and body when treating fatigue
Dr. Evan Hirsch: Yeah, I think that that will be great. So in terms of mold, I wanna come back a little bit, touch on the testing because I didn’t get to talk about mold. You know, we always wanna see what’s in the environment for mold as well as what’s in the human.
So the best test in the human is a urine mycotoxin test by Real-Time Laboratories. I don’t know if that’s on directlabs.com, you can check it out. But this is looking at those mycotoxins so basically those 0.003, 0.0003-micron toxins that are really causing a lot of the problem inside the human. That’s something, that’s a test that we like to use to determine when do we stop treatments, so that’s a great test.
There’s also testing in the home that we want and that can be done by Real Time Labs by taking a hair sample. The best test is an ERMI test, E-R-M-I, excuse me, I think it’s by a company called Mycometrics, and it’s inspired by of Dr. Richie Shoemaker who's a big mold guy. It’s looking at the DNA of the mold, you can also do mold plates that you find in your local [inaudible] stores and stuff like that, and it’s a pretty good test. If you got mold on those mold plates you know you’ve got it, but if you don’t, it doesn’t mean that you don’t. It's nebulous, it's hard to figure out, it can be hard to treat and it's really challenging to remediate your home.
If you’ve ever had any sort of water damage in your home, any flooding, you have to evaluate it for mold.
What to do to take mold out of the equation when treating fatigue
You have to take the mold out of the equation. One of the ways you can test and see whether or not your home has mold is to go on vacation.
So if you go on vacation and you feel better, you know you go to I don’t know, Hawaii or something, Hawaii has a lot of mold because of the moisture, but if you go on vacation for about a week and you feel better maybe it’s not because of your job.
Then you’re like, "Oh, I feel better because I don’t have the stress," maybe it’s because you have something wrong with your house, you have sick house syndrome. Then those mycotoxins also get in all of your clothes and they get in all of your furniture, so when you leave that home, you actually have to leave. It's recommended to leave all that stuff and I have some people who don’t leave all their stuff and they basically take them all with them. So mold is a big old can of worms that absolutely has to be addressed.
Ari Whitten: Got you, and so the main strategy there is about addressing it in the home rather than in your body necessarily.
Dr. Evan Hirsch: Well you got to do both. You got to address it in the home and we can address it in the body at the same time, but we ... Yeah, you just can’t be exposing yourself on a regular basis and it’s an amazing ... It’s so amazing to see people get out of their homes and see the improvement in their health while we're doing the glutathione and doing the binders like charcoal or modified citrus pectin, and sometimes high dose IV vitamin C and oxygen therapy, ozone therapy. So there’s a number of things that we'll use in order to get the mold out depending on where the person is at in the process.
What you can do to treat mold in your home
Ari Whitten: Got you. In the house itself this would be mainly a matter of bringing in like a mold specialist to identify or using the mold plates or something like that to identify if you have that issue, and then bringing in a mold specialist to identify where it's coming from, maybe clean in out, or something to that effect?
Dr. Evan Hirsch: Yeah. Your best bet is to find a building biologist. If you google that in your area there are some organizations that train this building biologist and sometimes they have enough training to come in and counsel you about EMS as well, which is really awesome and a whole another ball of wax.
But yeah, the challenge with the molds specialist is that oftentimes they ... You can spend 10 grand on remediation and it’s not that right. So they may claim themselves to be a mold specialist, but if they don’t have a guarantee like you really want somebody who's gonna do before and after testing. And that if afterward if they repeat the testing and it’s the ERMI test or it’s a real time lab air test and it still shows a positive that they do it again for free.
The benefit of using an air purifier for removing mold
Ari Whitten: Okay, that’s good advice. What do you think of air purifiers, having air purifiers in your bedroom? Is that a good idea as well?
Dr. Evan Hirsch: That’s a great idea. Now the only air purifier that I know about that gets down to the 0.0003 microns is IQAir, so iqair.com is great. If you mention my name you get I think 10% off and I don’t get any money for that so you know, enjoy it, use it. They are quite expensive, they are 800, $900, but they're wonderful. They’ll take a thousand, 1,200 square feet and they can completely remove it from mold and mold toxins. So if you can’t get out of your home, if you can’t remediate, you spend the $900, you get this air filter and you just you wheel it around your house as you need to and you just make sure that you're taking care of yourself.
What some practical tools for removing hidden infections are
Ari Whitten: Okay, Cool. Okay, so now we’ve covered heavy metals, we’re covered chemicals, we’ve covered biotoxins, the last one is hidden infections.
I know that this is a hugely complex area when treating fatigue and it really depends on which specific infection that we’re dealing with, but do you have any practical recommendations for getting rid of hidden infections in the body?
Dr. Evan Hirsch: Yes, and this is one of my favorite things to talk about because the results can be so dramatic, and as we get better and better tools we see faster and faster results. The Cowden Protocol is a really good protocol for doing this, it’s a combination of Banderol and Samento that you can also get through our shop. It can get rid of Lyme and its co-infections.
What hidden infection to go for last
It’s not perfect, it doesn’t work for everybody. I should back up and say, you know we always want to go for the low hanging fruit first, we want to go for Lyme last because of some of these other infections, I call them the gateway bugs, as supposed to the gateway drugs. But gateway bugs where they will hijack the immune system and they will mess with it and then you won’t be able to get rid of the Lyme if you go directly out the Lyme.
So you have to get after the Epstein-Barr, the Bartonella, the Babesia, the [inaudible], HHV6 virus, like all these stuff first before you go after the Lyme.
The other thing is you have to go after gut bugs before you go after blood bugs. So we talked mainly up to this point around blood bugs, Lyme and all that but there are bugs in the gut, there can be yeast, there can be E.coli, there can be Proteus, there can be Klebsiella, there can be a number of different infections that are in the gut that isn't supposed to be there. SIBO, small intestinal bowel overgrowth is in the gut, it’s in the small intestines. The other ones that I mentioned are mostly in the large intestine.
How sinus conditions can be yeast, mold, or MARCONS
There can be infections in the sinuses. So the Mayo Clinic came out with a study number of years ago saying that 30 to 50% of all chronic sinus condition are yeast. Well, I’ve seen that it's yeast, it’s mold, it’s something called MARCONS, M-A-R-C-O-N-S which stands for Multiple Antibiotic Resistant Coagulase Negative Staph, would basically any antibiotic-resistant bug that’s up in there.
So there’s a lot of these different infections that can kind of hijack the immune system that had to be taken care of before you go after the big mama, which is Lyme or otherwise knows as Borrelia.
How patients often have co-infections
Ari Whitten: Interesting. You’re seeing people with co-infections who have lots of different layers of these different infections going on and not just Lyme, but some of these other viruses as well.
Dr. Evan Hirsch: Yes.
What the practical steps to clearing gut- and blood bugs look like
Ari Whitten: Wow. Interesting. Okay, so how ... You go after gut bugs before blood bugs. What does this look like in terms of more practical steps, more specifics?
Dr. Evan Hirsch: So if you’re gonna go after yeast there are some natural antifungals that can be helpful. It has to be combined with good probiotic and a really good diet. The diet is very challenging for many people, it has to be done for three months oftentimes, it needs to be done for longer than that. But it is a grain-free diet. It’s basically meat and vegetables, low glycemic index. Low glycemic index diet and then with a probiotic. So I like probiotic called the Ther-Biotic Complete by a company called Klaire Labs, and then the antifungals are a product called Yeast Formula, a product called Phytostan and they can be good.
Though a lot of times I have to get my patients on prescription antifungals so we’re talking about Diflucan, which always has to be taken with ... [inaudible] has a nice daily liver formula product because Diflucan can damage the liver. And Mystatin, which does not damage the liver, but it’s not as strong as Diflucan. Oftentimes I have to combine both of those and find that that’s the best way to not waste any time is to do both of those, do the diet, do the probiotic and generally in three months, you can get rid of yeast.
How cleaning out yeast can help with the sinuses as well
Ari Whitten: That would get rid of yeast not only in the gut but also inside the sinuses as well, thus help treating fatigue?
Dr. Evan Hirsch: It can, yeah. It can definitely help out there and sometimes you have to do like Mystatin flushes where you have to get some sort of antifungal up into the sinuses. Then yeast also is very hard to test for so you might not find it in your stool, but if you have itchy ears, if you have itchy anus, itchy skin in general, if you have depression, if you feel worse when you consume sugary food including fruit, you may have a history of chronic yeast infections. If you have toe fungus, all of those things indicate that you most likely have a yeast problem and you need to be treated.
What to do after addressing yeast
Ari Whitten: Interesting. Okay, so that’s how you address the yeast, what’s the next layer?
Dr. Evan Hirsch: So the next layer is the other infections that are in the gut, so there are several products that I like for this. GI Microb-X by Designs for Health is a good product, and then Para Biotic Plus by Biogenesis is a good product that I like to use. Generally, that will take three months or so with a good clean diet in order to get rid of that layer.
Ari Whitten: Okay. So that’s addressing bacterial issues mainly.
Dr. Evan Hirsch: Correct, and those are a combination of herbs, much like the other antifungal complexes are.
Parasites can be a problem when treating fatigue, how to treat them
Ari Whitten: Okay, and then is there another layer around parasites to this as well or do you find parasites a big problem for a lot of people?
Dr. Evan Hirsch: They definitely can be and those are addressed with what I just mentioned.
How to treat sinuses after clearing the yeast and parasites from the body
Ari Whitten: Okay, and what’s next?
Dr. Evan Hirsch: So the next step would be going after the sinuses, and so depending on which bug is present we may want to use a VEG spray or basically a combination of different antibiotics that have to be compounded, that need to go up in there. But we’re having a ton of success utilizing sinus ozone. So this is something that people can do at home and will kind of, you know, because the rectal ozone can be really great for dealing with a number of these infections long term, so you can purchase a setup for about a thousand dollars and get your own ozone at home. You can put, fill up a syringe, and you can put it up into your sinuses, and do it several times a week.
Ari Whitten: That’s ozonated water? Is that what you’re gonna use there for treating fatigue?
Dr. Evan Hirsch: No, you’re just going to use ozone. They have to follow a specific instruction for doing this. There’s a guy on YouTube, Truly Heal is the name of his website, name of his channel. I can’t remember his name, but he does a very nice job of training you on how to do this. We never want to breathe in ozone and this isn’t the ozone in the atmosphere, this is basically activated oxygen therapy. You never want to breathe it in so when you’re doing it up the sinuses you have to take a deep breath, and then put it into the sinus, and you hold it for as long as you can.
How oxygen treatment can be used to treat brain issues like Parkinson’s and dementia
You can kind of feel it because it’s a gas, some people are using this for treating brain issues like Parkinson's and Dementia. It also goes up into the ears. We had one patient who I just saw the other day who's been doing it three times a week, and when she first came to see us she couldn’t hear out of one ear for the last four years because of a mold exposure. So once we started doing the sinus stuff she’s now, a month later, she can almost hear entirely out of that ear.
Ari Whitten: Wow, awesome.
Dr. Evan Hirsch: Yeah.
A warning about treating fatigue and other conditions with ozone gas
Ari Whitten: So the reason that I asked if it was ozonated water is because I know that ozone gas is toxic to the lungs, so that way you explained it makes sense, that you’re taking in a deep breath, you’re holding and then putting the stuff up there, and then you’re exhaling it all out. Is that right?
Dr. Evan Hirsch: Yeah, and all of this stuff I recommend that you do it with a physician.
Why professional assistance is important for successful treatment
There are nuances to all these, you can get in trouble taking these things, and the improper doses and stuff like that. I’m gonna do my best in the classes that I have to train you, best that you can, when you have to find somebody knowledgeable in this sort of stuff and follow the recommendations to a T so that you can get the best the biggest bang for the buck.
Ari Whitten: Yeah, for sure, and there’s obviously a ton of complexity and nuance to all the different things we’ve talked about to this point, and I think everybody would be smart to get professional guidance for doing any of this. But I think it’s also, at the same time, I think it’s awesome that people are hearing this blueprint for how you approach things very systematically and progressively because I know so many people out there are just ... There’s this tendency, I think, this human tendency towards finding the one thing. You know, oh, it’s this one treatment, it’s high dose IV Vitamin C therapy, and that’s the thing that’s gonna cure all your problems.
Or it's this supplement, or it’s you know, whatever. We all want, it’s this diet, we all want this one thing, and I know that there are so many people out there who are just trying one thing after another, after another, after another, and they basically just jump from one thing to the next. They're like, "Okay. Well that thing, I thought it worked for a few weeks and then it stopped working. This thing worked for a few weeks," and they end up just wasting their time for years, and I think it’s awesome that people are hearing from you that there’s this blueprint. You need to address all these different layers of the puzzle very systematically and intelligently.
So yes, get professional guidance on all these different steps, but have this blueprint in your head for how to go about the big picture of actually getting real results.
Dr. Evan Hirsch: Yeah I’m glad that you said that because I mean that’s huge and it may be that if the treatment works for your friend and then the treatment doesn’t work for you, it’s just because you’re either treating, you’re not treating the right cause. Or that treatment may work for you, but it may work for you several months down the line.
Ari Whitten: Right.
Dr. Evan Hirsch: I do want to be clear, I do have to say that you know, I am not treating anybody who’s watching this. We do not have a therapeutic relationship. This is just based off of ... This is just education and it's based off of what I do with my patients.
Ari Whitten: Yes, absolutely. Yeah, I think that’s clear and I’m glad that you said that just in case it wasn’t. So are there any other layers to the story that you would address after? What was the last thing we talked about? What was it?
Dr. Evan Hirsch: Sinuses.
How IV ozone is used to treat blood infections
Ari Whitten: The sinuses, the sinus ozone. I know we have talked about on phone at one time. You had just finished doing an IV ozone section on yourself. Can you talk a little bit about IV ozone?
Dr. Evan Hirsch: Absolutely, and that kind of leads into the next part, so we talked about infections in the gut, infections in the sinuses, and then we would be able to deal with infections in the blood of which we use IV ozone or rectal ozone, which you can if you get this stuff at home you can utilize that rectal ozone for the rest of your lives. You get a sinus infection, you get an ear infection, you want to treat your bugs. Ozone is amazing. We just talked about not having a [inaudible] and ozone is not a [inaudible] so it doesn’t work for everything, but it’s the closest thing that I have found.
It’s activated oxygen therapy so as soon as it hits the blood, or as soon as it hits the mucosa it's going to be converted to oxygen, and it’s been shown to decrease inflammation, a number of inflammatory markers go down, it’s antimicrobial so it kills bugs, it can detox though it’s not gonna be able to detox your heavy metals completely maybe over the course of five or 10 years, as well as chemicals. It rebuilds and boosts mitochondrial function by several hundred percents, so it’s just ... Then it also, it heals a lot of vascular injuries so it’s just a wonderful treatment all the way around, doing it IV, and then doing it rectally at home are great options.
Ari Whitten: Cool, so IV would only be in a doctor's clinic, is that right?
Dr. Evan Hirsch: Correct.
Ari Whitten: Okay. But rectal and the sinus options are something that could potentially be done at home if you have an ozone machine?
Dr. Evan Hirsch: Correct.
Ari Whitten: Okay. Also, just a question on the mechanism here, you said it turns to oxygen as soon as it hits the blood or the mucosa. So how does it actually exert say antimicrobial effects if it’s just oxygen in the blood?
How cancer cannot live in an oxygenated environment
Dr. Evan Hirsch: Oxygen does that. In 1933, Otto Von Warburg showed and won the Nobel Prize for proving that cancer could not live in an oxygenated environment. Since then, a lot of his students have proven how oxygen is a natural antimicrobial.
So one of the things that happened is that there’s this preservation, the survival effect that happens inside the human organism in order to protect itself. So it clamps down on all of its vasculatures and so the infections are basically dictating this and so that they can live and they can live in thick blood and create their biofilm and all that sort of stuff.
When you start adding oxygen and you start increasing the blood flow throughout the body, that ends up breaking up a lot of the infections and it has some antimicrobial activity on its own. But then it also allows the immune system to start killing off the infections.
How saunas and ozone combined can increase circulation
Ari Whitten: Interesting. Now that you’re talking about circulation, what immediately popped into my head was saunas and I wonder if there’s any synergism between say ozone therapy and sauna use to really increase circulation even that much more and that can help treating fatigue.
Dr. Evan Hirsch: There definitely is, there are ozone saunas.
Ari Whitten: Oh, interesting.
Dr. Evan Hirsch: They also will combine P Pulse DMF in some of those. The other thing about saunas is that the far infrared sauna actually kills infections the wavelength that the far infrared is on will cause antimicrobial activity.
Ari Whitten: Really?
Dr. Evan Hirsch: Mm-hmm (affirmative)
Ari Whitten: Wow, that's cool.
How raising your temperature can help treat infections
Dr. Evan Hirsch: Yeah, as well raising your temperature so you know the old phrase, starve a fever, feed the colds.
Ari Whitten: Yes.
Dr. Evan Hirsch: I starve everything. Yeah, I starve everything and you want to heat everything. So the body function is better when it doesn’t have to eat because eating takes up a lot of energy, so if you can use that energy for your immune system, so fasting on liquids and then getting really warm, increasing your body temperature causes the immune system to function that. That’s why you get a fever, and so the more fevers that you can have, whether it’s going into a sauna or taking a hot bath with some Epsom salt or whatever, those can be really helpful for killing infections, too.
Ari Whitten: Got you. Okay, I just have a quick note, I think we actually got that backward, I think it feeds the fever, starve a cold.
Dr. Evan Hirsch: Thank you.
Why sleep is important, and how Evan is helping his patients sleep at night
Ari Whitten: Okay, awesome. So is there any other ... I think we’ve covered just about all the usual suspects and how to actually go about fixing them, understanding that there are new ones, some complexity and that it’s best to do all of these things under professional guidance.
Are there any other things you think are worth mentioning here? We’ve talked about hidden infections, we’ve talked about biotoxins, we’ve talked about chemicals and heavy metals. Anything else that you want to mention on top of all the strategies that we’ve discussed?
Dr. Evan Hirsch: I would, I would like to touch on just a couple of things. So we haven’t talked about sleep, we haven’t talked about exercise, which you really do a good job of those things. One thing I would like to mention about sleep is that I get more people to sleep at night by giving them things in the morning that I do by giving them anything at night. So generally if I give them if they're deficient in these things B12 adrenals, thyroid, iron, I give those in the morning. Iron is separated from thyroid by two hours, but if I give all of those in the morning, that will help people sleep at night.
Now women who are menopausal they’ll still generally need progesterone to help them fall asleep and estrogen to help them stay asleep but if they’ve done all of your tools and techniques, the circadian rhythm they feel like there’s been fix to an appreciable degree, they're doing everything, and they're still having issues, it could be that they have this nutritional and hormonal deficiency that might be playing role.
How infections can keep you awake at night
Then infections also play a role. Infections are really active at night. So they’ll wake people up throughout the night sometimes and on oftentimes to urinate, people say, "Well, I have to get up to urinate," and that’s not the reason why you’re getting up. You’re getting up because you’re not getting into deep sleep and then your body is not shutting off the need to urinate, you’re not going into your parasympathetic when you’re sleeping. You’re awake enough to be woken by a full bladder.
You should be able to drink you know, 20 ounces of water half an hour to an hour before bed and not have to wake up throughout the night and that’s because the mechanism for urine is shut off while you’re sleeping. So the infections, as well as those other things that I mentioned, will affect your ability to get into deep sleep and as we treat all those things and sleep will greatly improve.
Ari Whitten: Cool, interesting, another layer I did not know. So thank you for educating me at the same time here. So that’s real yeah, as you were talking I was having recollections of so many people complaining of that exact symptom and you know I’m trying to address it to a lots of other strategies, but that’s one piece of the puzzle for me, that I’m sure, has been going on and some of these people that I haven’t been effectively addressing. So awesome.
Sleep obviously is just massive. I mean if you’re not sleeping well, none of these other things are gonna work, you’re not gonna fight off, in fact, you’re immune system is not gonna work well enough to fight off infections and detoxify and do exercise or really function at all if you’re chronically sleep deprived. So yeah that’s huge.
Awesome, I think we covered just about everything here. Any other last tips you wanna add here, or have we pretty much covered it all?
Why treating fatigue means going to bed around 10 pm
Dr. Evan Hirsch: I’ll say one little thing, one last thing, well one last thing at sleep and one little thing on exercise, so I tell my patients I never seen a patient who is treating fatigue get better if they’re not going to bed at 10:00, 10:30, so you have to do that.
Find your exercise tolerance level
Then with exercise, you know, really is, it really depends on your intolerance to exercise.
You have some people who do five jumping jacks a day because their fatigue is so bad and some people they can’t do anything when doing something. You know, when you talked about movement it's just so important. If there is a panacea it's exercise, you know the exercise modulating so many things, it improves so many things and if you can just you know if you can prioritize it and you can do it that’s awesome.
I guess the last thing I would say is, you know it really is all about foundations. My wife has a website called life takes practice where she talks about more about these, but that you’ve also mentioned about sleep and nutrition and exercise are all huge and then and imagine you’re stressed and make and maintaining your communities and your social you know, all those things are just so super duper important and you have to foster which will aid in treating fatigue. It seems overwhelming, but you have to foster all those things while you’re also going after all the usual suspects and the nutrients and hormonal deficiency.
It can be a daunting task, but if you’re being held step by step and you’ve got people like Ari and I to help you along the way, it’s totally manageable.
How to get to know more about Dr. Evan Hirsch’s work
Ari Whitten: Awesome, I love it so the last thing is I want to recommend to you everyone here, to take advantage of Dr. Hirsch's program where he's gonna guide you step by step and really walk you through a lot of the different strategies that he's talked about in this interview. So where can people go to get information on that?
I know you’re just wrapping things up as far as that program is concerned and getting things done, when that’s out, which it will be for probably a lot of people who are watching this you know, several weeks or months from now, where can people go to find information on that and get that program so that you can walk them through all these different strategies?
Dr. Evan Hirsch: Yeah, so go to fixyourfatigue.org and put your email address in there to download my free e-book so you can start treating fatigue for yourself, and to get on my newsletter so that I can let you know when things are being launched. We’re in the process and we’re moving things along, and I’m really excited about sharing with people. It's gonna come out in the next several months and there’s a book in process that I hope to launch in early 2017.
Ari Whitten: Awesome, well I’m looking forward to reading it myself and to sharing it with my audience and thank you so much for coming on and sharing all these wonderful information on treating fatigue with us.
Dr. Evan Hirsch: Thank you, Ari it was a lot of fun talking about treating fatigue
Ari Whitten: Yeah, thank you.
If you enjoyed this podcast on treating fatigue and you want to know more about how to treat hidden infections naturally you should absolutely go here and check out the podcast I did with Guillermo Ruiz on how to boost your immune system.