#423: Detox Pathways, Sensitive Systems, and the Truth About Chelation Therapy With ​​Dr. Nafysa Parpia

Welcome to Longevity. I'm your host, Natalie Knidham. I'm a nutritionist, a human potential and epigenetic coach, and I created this podcast to bring you the latest ways to take control of your health and longevity. We cover it all, from new technology and ancestral health practices to personalized interventions and a very special interest of mine, peptides and bioregulators. Enjoy the show. Welcome back to the show. I'm Natalie Knidham, your host. Now, if you've ever wondered why some people just don't ever seem to get better, it doesn't matter how clean they eat, how many supplements they take, or how many doctors they see, they just can't get it to move. Now, this episode might just help you to connect some of the major dots. I'm joined today by Dr. Nefisa Parpia, board-certified naturopathic doctor and director of naturopathic medicine at Gordon Medical. Here she specializes in complex chronic illness, everything from Lyme and mold to long COVID, MCAS, autoimmune conditions. These are the baddest of the bads. These are the ones that people just can't seem to get their heads around and most doctors just can't seem to move the needle on. We talk about the hidden role of environmental toxins, why menopause can unmask a lifetime of toxic burden, and how therapies like peptides and bioregulators are changing what recovery looks like for highly sensitive patients. Now, if this episode resonates for you, you'll be able to learn more about Gordon Medical by going to gordonmedical.com. Next up, we're going to thank a couple of our sponsors that so generously make this episode possible and have amazing offers for you. And then we're off. Just as you have an immune system, you also have a built-in repair system powered by stem cells. These cells help renew and repair your tissues every single day. But by your 30s, circulating stem cells can decline by up to 90%, which limits your body's ability to recover. 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You can say 15% at bioptimizers.com forward slash bio NAT, and use code BIONAT for 15% off any order. Look, it's not about knocking yourself out, it's about supporting your body in the way it was designed to work. Welcome to the show, Nafisa Parpe. I am so happy to be speaking with you today. I am so happy to be here. I'm just very excited about this conversation. We've met now a number of times under different circumstances. And you know, one of the many things that I love about you is the it's the humanity that you bring to the approach that is deeply connected and deeply rooted in science. So it's not something that we always see in science. And I'm really excited for this conversation for the audience, because I think they're going to get a very unique message in a very beautiful fashion. So thank you again. Thank you. I appreciate that. So in getting started, you know, you have an expertise in environmental medicine. So what really got you there? Like what, you know, also like you're in this whole nuance space, like the heavy metal space, mold, chronic complex illness, and particularly in women. And a lot of what I'm seeing is there's a lot of noise. There's people who dismiss these things right out of hand. Then we've got people who seem to hyper focus on these things. And is it possible that there's a bit of a hyper focus in some areas? But let's talk about you first and what really got you into this space and focusing particularly on women. Yeah, you know, I, I knew a long time ago that there's a healer in me. I knew that I wanted to work with people, but not just as a doctor working on only their yeast infection or only their toenails fungus. I wanted to go deeper with people. And I understood that when you brought up humanity, that's the part I'm talking about that piece that where the spirit meets the bones, where the biochemistry meets what's happening internally in the person. And so I knew that it was in that space of complex chronic illness for sure. As far as working with women, well, I think it's because I am one. And I understand what what women go through in this world, what they have gone, what I think they continue to go through in their bodies, but also just just by function of being alive as a woman on this planet, things we experience. And how I see a lot of what happens in women's lives, like their traumas, how that intermingles with sickness. Talk a little bit about that later, but that's really what drove me to enter my practice in that zone specifically. You went a little deeper down a particular funnel here of the environmental medicine. Like what what pulled you into that space? And again, you know, it's interesting because you're bringing a particularly female perspective to that. And we both know that medical research on women has been sorely lacking. We have decades of lost time to make up for. But what what took you down the environmental medicine route? You know, I'd see I'd see these patients with complex chronic illness and illnesses that didn't exist 20 years ago. Illnesses that I was in medical school, starting in 2005, naturopathic medical school, they didn't even teach us about because they were kind of rare. Illnesses like long COVID, that's a new one. But that's a new one. I'd say illnesses like Lyme and co-infections, more autoimmune conditions, fibromyalgia, ME-CFS, these were more rare conditions. And then over the past 20 years, they've become more and more common. You know, wonder, well, why is this going on? Well, we have more environmental toxins. Speaking of long COVID, you know, we actually, you and I had a conversation about long COVID in the past for your summit, but the spike protein can be can act as a toxin to some people and create the inflammatory cytokine cascade that then eggs on other illnesses. And so it's this toxin load that is that is not allowing us to walk hand in hand with chronic infections or not allowing us to walk hand in hand with mold or Lyme disease. And so I just knew that if I just start to try to address patients who have complex chronic illness, and I know they've got multiple chronic infections, if I just try to kill the bugs, it's not going to get me anywhere. They still have high mercury, high glyphosate, microplastics, for effort chemicals. Yeah. All of this. Well, yeah. That's why I love that. Yeah. All right. So when, when did you first notice that connection between hormonal transitions, like menopause and toxic burden? You know, like, was there a moment or patient story that really kind of went, uh-oh? There's something here. I'll say it was, it was when I was learning with Dr. Paul Anderson and Dr. Lynn Patrick, and I was taking a class a long time ago in, in chelation therapy with Dr. Paul Anderson. And he was talking about lead, about women, when women in menopause, we tend to lose bone, even if we have a diagnosis of osteopenia porosis, or we don't have that diagnosis, we still tend to lose bone. And lead gets stored in our bones, our bones, our repositories for lead. We all get exposed to it, even though it was banned a long time ago, it doesn't, it just gets recycled, doesn't buy a degrade. So it goes into our bloodstream. The half-life there is 70 days, and then 90% of the lead blood gets stored in the bones. Then we start to lose bone. And lo and behold, we can become our own, uh, our own toxicity center. Our own source of toxins. Yeah. Yeah. The lead starts to leach out into the blood. So when he told me this, I thought, okay, now I need to start testing this in my patients. That was a long, I don't know, 10, 12 years ago, something like that. And since then, I've been testing it. And I see it every day in my practice, high lead in women's blood. I'm not talking about a provoke test, just straight up. What's in your blood? It's high. And then you're a vessel. I thought I saw something recently. The problem is it was on Instagram, and you didn't have time to dig into it. So I'm, you know, I'm pretty cautious with the stuff I see on Instagram. I think that, you know, people, you can get really good information from there, but definitely you need to hear due diligence. But there was a post that talked about, and I think it was lead in women's lipstick. Is that a, is that something you've come across? Like, do you think there's, because I, like, especially in those very deep red pigments? See, lead was banned in the 1990s in America. It was started to phase out in the late 1970s. But in the dark pigments, if they were made in another country, sure, there, there are, like, another country where it's not as stringent. Regulated. Yeah. So probably that's not it. I mean, definitely lead. I mean, you get lead from the air, right? If you live in a major city, there's a component of lead in the air. Absolutely. And then where else do we get it from? Well, houses built before 1978, they had lead pipes, a lot of patients, I'm finding lead in their water. So now imagine I see a patient and it happens every day, their lead is unacceptably high in their blood. So now I start to think, okay, do you have bone loss? Do you have osteopenia? Do you have osteoporosis? Where are you getting this lead from? It's not only menopausal women, by the way, men. I have a patient who's a young woman. Well, yeah. Because they've got, because these people have persistent inflammation, some people that persistent inflammation meets their bones. But anyhow, back to what do I do when I see this? So I wonder where is it coming from? So I'm testing and telepeptide or C-telepeptide to see if there's bone loss, send them for a dexa scan. I'm also testing the water and I'm testing the blood. And people, there's lead in their water and they have bone loss. So now I'm like, wow, this is a double whammy. You've got bone loss and you've got lead in your water. Wow. Okay. So it's not that uncommon. I literally recently just had a full body, a full house filtration system put in because, because, you know, again, like so many of us live in old cities. Yeah. And our pipes in our house may have been upgraded, but we have no control over what's coming in from the street. And it could be our street, it could be 10 streets away. You don't, you know, none of these cities have the resources to really upgrade the infrastructure like they need to. In fact, I have a patient like that. So speaking of patient stories, so her lead is sky high. She does not have bone loss that's been corrected for already. So I'm like, where is it coming from? Okay. It's not, she just had a water filter put in. And I'm like, you know what, it's got to be from, from the city. So now she's going to be testing her neighbors. We're going to see. Is that, is that what it could be? Could that be it? Yeah, that's, that's so interesting. I want to do a little sidebar on chelation therapy a little bit because people talk about it a lot. People love it. People hated it can be very difficult on the body, maybe help the audience to understand like, when is it really necessary or where can you just eat chlorella? You know, or whatever. That's, that's an important question. So I think that first of all, there's so, there's so many pieces to that question. First of all, as it comes to chelation therapy, there is, there's the right way to do it. And there's a wrong way to do it. We can talk about this later on. It's a big piece of what I want to talk with you about today. The right way to do it is to support the entire system to do depuration, not just do a cellular detox. When we're doing chelation therapy, we're using substances like EDTA and DMPS sometimes go to thion to pull toxins from outside of the cells, then the toxins recirculate. And when we're not chelating the right way, when we're not adding that in to an entire depuration process, we can then recirculate the metals. That's why it's hard on the body. And I'll, I want to talk more about that later. But to answer the question about when is it appropriate to chelate? And when is it not? If somebody has an acute exposure right here, right now, it's not appropriate to chelate, we've got to get them out of that exposure. And then I'm doing a, I'm testing, I'm doing a pre-provocation test and a post-provocation test of pre-provocation is what's in your blood, what's in your urine, that means what's coming at you right here, right now. If it's at an unacceptable level, but it's not considered acute, and I'll go into what does that mean, what's acceptable, what's unacceptable with respect to levels, but it just say someone's lead is high enough that I know is contributing to pathologies in their system, but not high enough that it's considered by a gold standard to be acute. Then I'm running a post-provocation test, a chelation test to see if that, those substances are actually addressing that. If those levels are much higher, post-provocation, then I know that this is going to be a therapy that works to pull those talkers out, right? And if you want to compare the pre-provocation to the post-provocation, if there is around five to 10% increase, then chelation is warranted. Yeah. And then otherwise, you might be able to use other strategies, oh yeah. ... gentler, not as, and then using the binders. I mean, I remember when I went back to school, one of the things that was impressed upon us over and over and over again, and I'll never forget it, is before you detox, make sure that the doors of detoxification, the pathways, are open because other, and that's the lymph, the sweat, the breath, the urine, the poop, all of those doors need to be flung open or you're just heading for another problem. Yes. And how do I fling those open with herbs that are specific to all those systems? With the bioregulators that are specific to all those systems? Oh my God, we're going to talk about that. Oh. Yeah. Well, okay. So before we go into next thing, a lot of people's ears will have perked up all of a sudden. So what are the bioregulators that you find are helpful in making sure that these systems are upregulated so that they're there to support what's needed when you're doing that work? Yeah. So I want to support the organs of elimination, the liver, the kidneys, the gut, you know, and lungs, and the lungs, absolutely the lungs. And the blood vessels, right? Yeah. The blood vessels, just said at the same time, the blood vessel bioregulator, it's so important that I have these bioregulators at my fingertips now. I didn't have them at my fingertips a year ago, two years ago. And so now I can incorporate that to make the detoxification protocol even more efficacious. And have you seen the needle move differently when you've implemented them? This is the question everybody asks, right? Because especially with the bioregulators, like with certain signaling peptides, like, I don't know, a thymus and alpha one or a GLP one, or whatever, people will use it and feel it. The bioregulator is a much more subtle process. So as a clinician, are you seeing an acceleration of results or outcomes? Yeah, 100% because my patient population are people who have complex chronic illness. These are highly, highly sensitive patients. In every way, they're going to feel everything. Some of them have to open up a bioregulator and put a toothpick in and take a toothpick dip. And that's enough. They feel that. You're kidding. Wow. Seriously, a lot of my patients, before I can even get them on the peptides, I use the bioregulators. This is because my patients have Mass Cell Activation Syndrome. And then their immune system, their Mass cells are not reactive only to foods and chemicals, but to all kinds of things. And so because the bioregulators are even more simple and structured than the peptides, highly sensitive, I'm so excited. I'm tripping over my own time. Sensitive patients can actually tolerate the bioregulators. You see how excited I am? There's nothing, nothing I've seen. People be able to tolerate these highly, highly sensitive people, then the bioregulators first. Yeah. Well, it's because they modulate, right? It's that, it's that, it's that, it's that their MO. It's modulatory, not, they're not going to boost, they're not going to suppress, they're going to support. So that's our restore function. Okay. All right. Let's get back to our regularly program program. We went off on a little sidebar there, but that's okay. How have you seen metals accumulate in women, particularly, that becomes so much more problematic during perian postmenopause? Like what's actually happening in the body with these metals? Yeah. So, so they're, they're losing the bone, right? And so there's the bones, obviously, but beyond the bones even, like, is there like hormone receptors that are being affected as they're also losing estrogen? Like, is that? Absolutely. So this, this, I call this, it's a nasty trifecta that I see in my patient population all the time. So they don't have enough hormone, or they have no hormone. Now they have bone loss. Now they have too much lead in their system. And so first of all, I want to talk about like, what happens when we don't have enough hormone in my patients, not everybody, but some people have a very, very hard time when they hit menopause. There is persistent oxidative stress, persistent inflammation, persistent immune dysregulation. So there's that. And then women have a tendency to disease processes they didn't have before. Hashimoto's, RA, lupus, we see diseases in women postmenopause, not so much premenopause, right? So we see these diseases in, research shows it has to do with a lack of hormones in certain people. Well, women's in persistent oxidative stress and persistent inflammation. And now she has lead. That's both of those things are going to contribute to a disease process. Lead is going to put the body into a state of persistent oxidative stress, persistent inflammation. And now people are more, their immune systems are more permissive to, to, to infections. So just common bugs that we see day to day, FCM, bar virus, for example, or mold. So now they're more apt to get infections in a way that they weren't before and only that, but the immune system was able to keep in check dormant infections, Lyme and co-infections, the herpes family viruses. Suddenly, a woman hits menopause and she's got high lead. And now she's got chronic Lyme disease. And she doesn't even remember being bit by a tick. Yeah. Yeah. So it's this reactivation. It's reactivation. Yeah. Yeah. That's, I mean, it makes total sense. Is it just lead? Like, dude, are you seeing this with mercury? Like there's a bunch of other heavy metals, right? That bunch of heavy metals. So actually, I think now's a good time to talk about, about the CDC's data. So, yeah, so they created this data set. It's called the NHANES data set. And it's a registry. It's a scoring system. And it's looking at environmental toxins that it looks at what's most toxic, what's most frequently found in people. And in superfund sites, it's called the NHANES registry. It's looking at thousands of Americans and it's updated roughly every four years. So now, if a patient, if a person is at the 75th to 95th, or even higher percentile, we know we want to consider that there's an acute exposure going on. And most people are going to have problems. If it's at 50th percentile, I'm considering an acute exposure. You know, the data says you don't need to consider an acute exposure at 50th percentile, but I'm considering it in pathologies related to low level chronic exposure are happening. So that's the thing, right? Because in conventionally, this is the classic conventional medicine approach. If you don't achieve a threshold, they don't consider it to be a problem. In functional medicine, you're looking at the delta and saying, at what threshold are we seeing like subclinical or, you know, we're seeing the effect, but it's just not getting picked up. Right. And in conventional medicine, in medical school, we're only taught toxicology. Like we're talking about, like toxicology is an acute, like large exposure that's going to put you in the hospital. I'm not talking about toxicology. It's a totally different subject. I'm talking about is environmental medicine, which is, it's not taught. It's like chronic low level exposure and then wear and tear the toll it takes on the system, which is so interesting. And, you know, what you've talked about around bone degradation and this kind of presentation where you have women, maybe even on hormone therapy, who can't get their levels up and whose bones are deteriorating, which also means that all the cognitive problems are happening. The cardiovascular risks are there, like all the other constellation of issues and, you know, bringing in this consideration of, well, why? Why is your estrogen not going up? Like, why is this estrogen not showing up and doing its work? Yeah, it's you've got these bad players getting in the way and preventing that from happening. Like, that's profound, right? Like, I might be one of those people, we might need to talk. In that data set, you're talking about other metals. Arsenic is number one. Yes. Let's do two. Mercury's three, cadmium is seven. There's 200 and I think like 240 or 250 toxins on this database. Metals are in the top seven. In the top three, lead's number two. So, I see all of these metals high in my patients. I tell my patients it's never just one toxin. Of course. It's never just, right? And it's never just one bug. So, I'm seeing glyphosate. I'm seeing microplastics, pesticides, solvents, forever chemicals, all kinds of toxins. And it's interesting, like, we think about, okay, if someone's at 50th, maybe 30th percentile, oh, I'm not supposed to consider that much of a problem. But what if they're 30th and lead and 30th and mercury and 30th and arsenic and they're super high in glyphosate? That's a toxic person. That person, that person's immune system, their endocrine system, their nervous system is being affected by these toxins. And God's being affected by the toxins. Well, and to your point, you're seeing people with chronic complex illness. So, these are people that have not been able to be helped within a conventional system. So, therefore, you have to kind of look outside what would typically be associated with that and say, okay, is there an accumulative load of small amounts of each of these things that's actually getting this person to the place where, and maybe overlaid with genetics that don't have, you know, great pathways for clearing stuff? Because I do believe, like, on a person, this is why not everybody has these issues. In some cases, I've seen on genetic panels, people with beautiful pathways for clearing stuff, and they seem to be able to do whatever they want. Like, it could be like those people that smoke into their 90s. Like, somehow they were born with a system that is able to clear that crap that gets into their bodies. 100%. I want to be so clear what you're saying is so important, Natalie, but this is not everybody. Some people sail through menopause and they are fine. I haven't met them in practice, but I've met them out in the world. You told me before you don't treat those people because they don't need to be treated. So, that's why you have a message. I don't need to. Right. So, let's talk about susceptibility. Some of you just talked about the genes. So, I'm looking at my patient's genes. It's really important. And what I'm looking at, what I'm seeing in these people is that they have SNPs, or I'd say, suboptimal genes in specific pathways, in their detox pathways, in their endocrine pathways, in their inflammatory pathways. Some of them in their cognition pathways, their metabolic pathways. So, I'm seeing this in the genes. And then, so I want to think about the genes, I want to think about exposures. A lot of them have malabsorptive issues. So, not enough amino acids, not enough minerals, not enough B vitamins on board. We need those in order to detoxify properly. We're just going to recirculate toxins if we don't have those cofactors on board. So, it's about exposures in genes and stress and uterine adequacy, the gut, all of the organs of a nation. Actually, that loops back to our talk earlier about culation and depuration. But these are the people who are susceptible. So, I have to look at all these things. I love that you said, look, this is not about everybody running around going, holy crap, I have a problem. This is more about understanding, you know, your unique terrain is going to affect your ability. And when you get stuck in a health journey, sometimes it's looking at these things that helps to really move needle for someone, which I would imagine you see happening all the time in your practice once you, you know, once you figure out that Rubik's cube of that individual because everyone is different, right? I love that you said that it is because Rubik's cube, I'm going to use that because that's what it is. They're all their own Rubik's cube. They are because, you know, we were speaking privately about Dr. Robert Navio and the cell danger response and his research around mitochondria. And, you know, one thing he said to me recently is that all of these, in almost all of these acquired complex chronic illnesses, how does someone get there? It's through thousands of different biochemicals that are unique to each individual. And those thousand different biochemicals meeting different genes that are unique to each individual. And then each person has their own expression of their illness that they have the same diagnosis that diagnosis about what end tissues are affected, right? Really, how they've got there is so different. That's really different. What that is in my mind. And he was saying there's there's no one single gene that's responsible for any of these acquired complex chronic illnesses. Yeah, that's so that's so interesting. The other thing I mean, it's and the challenge is, you know, how do we help more people because that is you are now getting into the most personalized form of personalized medicine, which, you know, people listening would be like, well, yeah, why wouldn't we just do that? You know, like even even pharmacogenetics, you know, I recently heard about someone who I actually I can't remember if they died or got morbidly ill from it might have been an anesthetic issue. We have that information. And yet standard of care is not to say is not there right now to say, let's look at this person's pathways of how they metabolize anesthetic. So we can understand do they is this person going to need more? Or might we be able to actually give this person a little bit less because they metabolize it so much faster. And it's, you know, I mean, on the one hand, it's inspiring, we have the information, it's this heartening that it's taking so long for the the conventional system to adopt these practices, or even to invite a patient to say, get us the information and we'll use it. And maybe there's not enough clinical side clinical trials behind it. But I think it's at least some of these major pathways are fairly well understood. I think so. And I mean, I have many patient stories where they say, you know, I got my genetic work or I did, I did a certain test and I asked my doctor to look at this and the doctor said no, they don't think yeah, I mean, and what can you do in an eight to 15 minute visit? And there's I mean, there's medical liability, right? I mean, I think in defense of the conventional doctor who sadly gets beat to a pulp in many of these interviews, I just want to say, you know, that we need to acknowledge that they have been given very tight guardrails. And they are not, you know, they're not. And that's why so many are leaving conventional medicine is because they're realizing that the confines, the confines put around them prevent them from practicing the medicine that they know is really going to help people. And that's I think it's sad. I think I don't think they I don't think most of them mean harm. I think most of them want to do the best they can. But the system and even from a liability perspective, like it's it I'm sure looking at someone's genes and saying let's titrate and anesthetic differently would open up a can of worms. I'm sure people went into medicine because they want to help people. They're good souls. You don't go into that and go through getting squeezed like a lemon through medical school. She don't care, right? So these are don't get possessed. Everything. All right, let's let's get back to our bones. And one thing I wanted to point out to the audience that I would maybe you can speak to is they do that at the expense of the minerals that need to be there. Because and and that's where that's the crux of it, right? Because for whatever reason, just like chlorine and fluoride have a higher affinity for thyroid, that thyroid hormone backbone than iodine, these heavy metals have a heavier charge than the calcium and the magnesium like the things that we actually need on our bone. And so, a they can displace but B you can take all the calcium and magnesium on the planet, even if you're with your D three and your K two and all the boron and all the things. If you have actual heavy metals sitting on in that bone, it's cemented until you drag it out of there. Here's the thing. I can't measure how much lead is in there. Yeah. So yeah, say I'm killing someone and it's and it's safely done. And I see that the lead is coming down from testing. I see that body burden drop. I'm saying, yes, this is excellent, right? What's that body burden from the lead? I mean, sorry, from the bones, yeah, from the bones. Well, most of it probably is because most of the are the lead gets stored in the bones. The other the other metals, the mercury lead, sorry, mercury arsenic, cadmium, they're going to get stored in the organs like using the thyroid, the kidneys, the liver arsenic loves to get stored in the kidneys. So when we're pulling lead out, if most of it isn't the bones, it probably is coming out of the bones when you pull it out. But I'm not sure you don't have a task. You don't have a task. And now you know, you would think if somebody was interested enough, they could develop that test. But anyway, we'll leave that for another day. Let's talk about heavy metals. Last question on heavy metals is, how does it how do they interact with inflammation pathways? Because again, I think you spoke to it a minute ago, talking about oxidative stress. But maybe let's just finish on that point here about, you know, how those heavy metals impact inflammation, and then the hormonal signaling, again, and the people that are, I mean, I'm sure it's hitting men as well. But when a woman is going through this menopausal transition, she's so vulnerable that it's really showing up there. It's really, really showing up. And so, so these women who are, first of all, more susceptible to amuse immune system dysregulation, because of lack of hormone, when the immune system is already in a state of dysregulation, I'm talking about a hyperactive immune system and a weak immune system, simultaneously, meaning a lot of these women, they've got Hashimoto's or another immune condition, and they've got Massal Activation Syndrome, and that's hyperactivity in the immune system. And yet the immune system is weak. I can see their white blood cells are on the low side. They're permissible. The immune system is more permissive to chronic infections. So this, this, I tell them it's like having an untrained fighter in the ring. Now, the immune system, that untrained fighter is throwing kicks and punches, but in the wrong direction and at the wrong person. And so we need to bring that into alignment. Actually, we've talked about this before, I use peptide therapies in a massive way to bring the immune system into alignment. There's nothing. I all means go down the rabbit hole. Again, people's dares, we hear peptides by regulators, like really, what do you mean? Yeah, I really, I got really, really into the peptides nine years ago. At the same time, I'd say that the biohackers started to get into them, but the doctors were not yet into them. The doctors are starting to get into it now, but I became obsessed with the peptides because I knew I'm still obsessed with them. And the biorethics, there's something here, there's something different. These are signaling molecules. I don't have any other substance that is a signaling molecule, like a peptide. And back in the day, when I trained with Dr. Klinghart a long, long time ago, after medical school, he would say you want to modulate the immune system first. So then we try, I would try when I got into practice, oh, vitamin C and mushrooms and all the herbs to modulate the immune response didn't work. Well, it blows it up and brings it down. Yeah, 100% didn't work. So I was like, well, this is nice in theory, but it's not going to work. Nine years ago, when I could get my hands on peptides more easily, I was like, this, this is how we're going to modulate the immune system. And, and I do. So starting, actually, often starting with lorazotide, totally going on another path that is okay. No, because lorazotide is going to seal the gut, which is going to calm down the the immune system, because the, all the LPS getting through the gut pisses off the immune system. So yes, take, I mean, you're, you're basically, you know, this is this is the theme, right? If you want to stop a process, you have to get to what's driving it in the first place. So please share lorazotide. Why is it your first line of the right. So these patients who have mast cell activation syndrome immune system dysregulation, they're said this earlier, but I want to talk a little bit more. They're, they're sensitive not only to foods and chemicals, they're sensitive to the different, I'd say the signaling in the body when it's out of whack, right? Yeah. So if I'm sealing leaky gut, I'm preventing antigens that should never cross into circulation and preventing that from happening. Because when those antigens and toxins cross into circulation, they're tripping up the mast cells. And like you said, pissing off the immune system. And, you know, so lorazotide, I've never seen anything be more efficacious in treating leaky gut than lorazotide. So yeah, starting with that one, the first, and then I'm starting to use the peptides that, that are for mast cell activation syndrome, amlaxo nox. It also helps open up the airways. A lot of my patients have that issues used for chronic rhinocytus, rhinocyanocytus, they've got inflamed sinuses, they've got issues with insulin, it helps with metaflamation. So I love amlaxo nox for those reasons. And people's mast cell activation syndrome starts to calm down when I give them amlaxo nox. KBV is another mast cell stabilizer, but it also has antimicrobial effects against Candida and staff, right? A lot of these patients have Candida issues. If I give them KBV right away, it's hard on their system for that reason. So it starts to kill the Candida. And they're not ready to die off. Yeah. So I'm like, okay, KBV later, you're gonna come in later. Loracetite, amlaxo nox. I'm also giving some low dose naltrexone and maybe getting ketotaphine and chromolin from the compounding pharmacy, stabilize the mast cells as best as I can. Then it comes in KBV. And then I've noticed though, if I'm to give TB4 or GHK, before I treat that mast cell activation syndrome in the patient population, those peptides could trip up and cast because they're more the repair peptides and the immune cells might take that as a threat. The immune cells at this point think that everything is a danger, including the animals. Okay. So back to the bioregulators. I'm starting with the bioregulators for whatever system the patient is out of balance. Yeah. Either thyroid, you know, the thyroid bioregulator and all of the organs, the blood vessels. And the thymus gland, I would think. Thymus gland, all over the person. That's huge. Yeah. It's huge. And so that's more coming to their system than bringing in the peptides that way. And then when the patient is ready, I started treating infections, TA1, LL37. A lot of these patients have autoimmune conditions, but LL37 can exacerbate autoimmune conditions. So they're not getting LL37 until I can modulate the autoimmune response. I'm really sequencing. I had to really think in depth about how I'm going to sequence these peptides for this patient population. Yeah. I love that you are saying this because, and this is one of the most important conversations I think around peptides that is, it's kind of starting to happen. And I think it doesn't happen often enough. And that is that, you know, peptides are so tempting to the N of 1 enthusiast. And even people, you know, we have the biohackers on one side who'll do throw anything in their body if they think they're going to get benefit of it. But even in the, I'm sure you see this in the chronic complex illness situation where someone has been gaslit, they've been told there's nothing wrong with them. They've no options. They don't know what to do anymore. And now they start looking at, they go to Reddit, they go to Facebook, they go to wherever, and they come across enough of this stuff that they're like, okay, this is going to help me. And I think the most important message to that audience, and, and yes, this can absolutely help you. But in a situation where you have a system that is so vulnerable, and again, prone to over under reaction, whatever the case may be, the order of operations, the guidance from a professional for you is going to make the difference between potentially sending yourself into a crisis, or at best, wasting a ton of money and getting no results. And that's not a good result. You know what I mean? Like, that's a crappy outcome. The worst case scenario is you're sitting in an ER trying to explain to someone how you just injected something into your body that you bought online that you read somewhere was going to help you that seems to have sent you into some kind of a crisis. I'm so glad you're bringing this up, because it's so common, right? So I'll have patients come in and say, I took TA1 and it was so bad. And I say, okay, the right peptide, but at the wrong time, right, the sequencing for these patients is crucial. And you brought up so many important points here. Like, first of all, buying it from someplace online, you don't know what kind of toxin is in there. Remember that study? I forget when it came out, but it was a Swiss study that showed that 80% of peptides just randomly online have some contamination and I'd say some extra substance in them that's not. Especially, yeah, I think a lot of the stuff coming in from overseas. I mean, look, there, the truth of the matter is overseas, we all know what I'm talking about, has the ability to make amazing product. The problem is that regulation is not great. So if they don't rinse the solvents out, if they don't test for toxins, if they don't test for how much is in the vial, and some people like, well, you know, my company guarantees there's more in the vial than they say there is, I'm like, that's amazing. And makes it literally impossible for you to dose. Yeah, like, how are you going to know what you're taking? Like, I'm just saying, it's great to get more when you get a bag of marbles and you get 40 marbles instead of 30 marbles, you can take away the 10 marbles. But when you get a peptide that's supposed to be 10 milligrams, and you get 12 or 13 or 14 and a half, and you really only need 100 micrograms, how the heck are you going to figure that one out? Right? How do you even know? You can't and you could be overdosing yourself right there or underdog what if there's less. Exactly. I mean, either, like, you know, I picked over because most people would say, well, I'm getting more for my money. And I'm like, yeah, you are. But that may not serve you. Anyway, okay. Good. That was another great little sidebar. So let's talk about the other stressors that come into play. All right. So you often and we do this is where we come to our bucket analogy, right? We talk about toxic, oh, toxic load. What have you seen be the side, the, the other players that will interplay with these things? And you may have mentioned some of them before, but I feel like some of them might not even be substances, they might be things like stress or whatever the case may be. What are the things that are pushing women into this overload? Is it the genetics? Is the lifestyle environment? The immune, like, what is it that you're seeing that's coming to play? I'm going to, I love that you brought up stress because it's a very interesting one. There are some people who they have trauma with a big T in their life and they never get sick. Yeah. And there are some people who have trauma with a big T in their life and they get very, very sick. That's a lot of my patients and some of my patients, their only trauma as if it's not big enough is the trauma of being ill and until they got sick, it was just little T traumas and they were fine with that. So it's not that everybody who has heavy trauma in their life gets sick, but it's that it's very often that patient patients who have these illnesses have a history of that kind of trauma and there's not enough, I'd say, internal spiritual, mental, emotional healing that's been done. Yeah. It's a time where they understand that often. They say, wow, at the end of it, when they, when they, when they can, not only at the end of their illness, but as they start to see results, and I'm going to have to say it's often with the peptides because that has been able to get me has helped me get them their lives faster. Someone would take me five years to treat on peptide therapies now two years, someone two years, one year, eight months. Wow. That is crazy. It's crazy. But anyways, so, so they start to notice healing faster because of the peptides and bioregulators. And then they start to say, you know what, I'm glad this happened. I'm starting to evolve in a way that I never did. I'm starting to really understand that I can have self sovereignty. I was talking to a woman today, I'm sorry, yesterday, a new patient and she said to me, she's had, she's had the life of major, major trauma, big T trauma after big T trauma and just mass electivation syndrome and a lot of complex chronic illness, including Lyme and co infections and all these toxins and somewhat early menopause. And she said, you know, it wasn't until I actually released my anger that I started to understand that I can have boundaries and, and I can have self sovereign self sovereignty. And I, I started to feel less, less sensitive. She's still highly sensitive. She has a ways to go, but, but understanding this piece, allowing the emotions to express, even if they might not be luminous emotions, as long as they're not stuck in non luminous emotions, that can lead to illness, I think. But if we, if we experience a spectrum of human emotion fully experienced it so that we can then move through it, that really helps with healing. Let's face it, you can't change your biology, but you can support it intelligently. A lot of products chase surface level results while ignoring what actually drives resilience underneath, communication. When signaling gets distorted by age, stress or environment, repair becomes less coordinated. And this is important and especially in skincare. Vitaly understands this. They first earned my trust years ago with pharmaceutical grade copper peptides like GHKCU, one of the most researched regenerative signaling molecules that we can get access to that actually naturally exists in your body. Now, Vitaly evolved that science by introducing exosomes, the body's native messengers. They use zero age exosomes, which means the signals driving repair are cleaner and more efficient. Paired with copper peptides, it's less about forcing change and more about supporting skin to do what it already knows how to do. If you think about longevity in terms of mitochondria, signaling and long term resilience, Vitaly is skincare built for your biology. All you have to do to get your hands on some is visit VitalySkinCare.com and use code NAC20 for 20% off. I don't know if I told you about this and I don't usually do this, but I recorded a podcast last week, this exact topic. And this is a physician who now who wrote a book called The Biology of Trauma, who ties together the impact of trauma on the physiology of a person and like both ways. And I would say that anybody listening to this, if you think you're one of these people, you need to go find this book. It's called Biology of Trauma by Dr. Amy Epiggin. And I'm only doing this on your podcast, Nafiza, because I think that what she explains, and this is going to be very short, is that one person's big T trauma is another person's little T trauma. And you're right. And your personal life experience will dictate whether that affects your physiology or not. So I'm going to leave it at that. I don't want to see it in my patient population. Exactly. And so I would invite anybody listening, even you like just check out her work because, well, you're seeing this in practice and it would be so power, so interesting to see how she's kind of brought these two worlds together. Because very often we're separate, right? Yeah, Eric recently interviewed her for our forum. We did. For the last one. Yeah, I don't know what their work, but yeah. That's exactly what you're talking about here, which, you know, so just to give it another shout you guys, like I think that didn't listen to Dr. Gordon's interview with her too. I think her work is again, it's going to be one of those bodies of work that I think is really can be very powerful for any number of people. Okay, let's get back to our women in midlife with brain fog. So what's the first thing because what I want to talk about is testing without over testing. I think that in a world where people couldn't test for stuff and they want information, people want validation, there's also this line of testing too much or testing the wrong thing or testing. So when you have a woman in midlife, she's got brain fog, fatigue, she's got all this other stuff going on. What's the first thing you want to understand before you start running these toxic, these labs on toxins or detox? Yeah, the first thing I want to understand is her, her terrain, the terrain of her own system. Basic labs, I'm just running a CBC and a CMP and a thyroid panel, sex hormone panel, adrenal. I'm just doing basic naturopathic functional medicine first. Because some people, all they need is their hormones fixed a little bit, their gut balanced, and off they go back to their life. I don't think you see that often in your population. I do that and they're like, okay, I noticed a difference. Bring on the peptides, bring on the bioregulators. And then I say, we need to consider the toxins. Actually, first run though, in my blood, in urine tests, along with thyroid and CBC and everything else, I am looking at metals because we're all exposed to them. Remember, they're in the top three, right? All the toxins. So that's just like, that just, it's round the nail. Yeah. Yeah. When I see that high, then I start to think, hmm, are you a poor detoxifier? Do you have snips in your genetic pathways? Where is this coming from? You have high metals, you have other high toxins, what's going on here? And it also depends on how sick the patient is. The patient is, if the patient is sensitive to everything, some people are even sensitive to water. Yeah. Is that patient? I'm not even going to want to detoxify them anyways, just yet they're not ready for detox. I can't start pulling toxins through a system that's completely depleted. Yeah. So I'm wanting to replete their system. I want to understand their nutrient status first. And then, you know, at some point after I've depleted them, I've supported their organs with the bioregulators, there's nothing like that, honestly, for this patient population, then I can start to bring in peptides for immune modulation. Yeah. And then I'll be like, let's test these things, you're starting to get better. Yeah, it's so interesting. You know, the nutrient replenishment that you referred to, what I think is we underestimate often is some, many of those depletions will affect your body's ability to function at a foundational level. And so if you restore that complete deficiency, even if it's like a vitamin, a B vitamin, or whatever the case may be, all of a sudden, something that wasn't working might start working again. I'm sure that what you find is it takes you like, it's like a domino effect, it's going to take you down the domino chain, and then you'll hit another block. All this work got done without you doing that much other than just providing something that the body just didn't have. Right. And some people, they can't take oral supplements because they've got a malabsorptive issue. One of the tests I'm doing early on is the microbiome. I want to know what's going on. I'm often testing what's in the sinuses. When we talk about menopause and brain fog, well, there's a big connection between sinus colonization of microbes that shouldn't be there. I see multiple different funguses or different bacterial infections and biofilm. If that's there, then inflammation from the sinuses, they can easily cross the blood brain barrier through the trigeminal nerve or through the, you know, just through nerves that connect through the criberform plate. So it's easy for toxins and inflammatory cytokines to cross the blood brain barrier. And then the brain fog is not only from menopause, so I correct from the, for the hormones, and they still have that. And I'm thinking, okay, what else? I am an attack on sinuses. And very often that there's bugs in there. Once I start to treat those, the brain issues start to come back. And then I start to use C max or C lang or other neurotropic peptides to help bring the brain back. Online the way it was to bring down brain inflammation. Again, people run to the C max and C length. But if there's a block, if there's a physical reality, why that's happening, I think that's where we're seeing people that don't respond to them and say, Oh, it didn't work. Again, you know, it's that guidance. It's that it's that clarity and guidance. Okay, so what, what are you seeing as the biggest testing mistake that you're seeing with well intentioned practitioners in this space? I mean, like, what's the biggest? Is it the over the under or just not getting? I think it's both. So honestly, there's a lot of infunctional medicine, environmental toxins, and chronic infections are missed when when the patient is kind of complex chronic illness diagnosis. But I want to be clear to people what those diagnoses are. It's long COVID that wasn't fixed at one of the long COVID clinics with one of the protocols. It is fibromyalgia, chronic fatigue syndrome. Those insidious ones. Yeah. So, so when functional medicine tries to treat those, usually they're balancing the gut, they're working on the hormones, they're working on the terrain, like I was talking about, it's so important to do that. So those are foundational steps. But then they haven't been taught how to detox, they haven't been taught how to deal with multiple low level chronic infections, kind of like multiple low level chronic toxins that that's where functional medicine just misses the boat. And so, so that's totally, totally missing. If they do test that, they don't know how to treat it. Okay, so people have to do a lot of extra training. If they want to get into this, so they might test, they might test, here's, let's get back to metals. What I'm seeing is doctors doing only a post-provocation test. So they're chelating the patient, testing their metals, and then saying, look, you have a high toxic burden. But you've pushed them out. Yeah. Yeah, you've pushed them on. I don't know, does the patient like, was that patient even ready for a probation test? They probably felt really bad with the provocation test that they had a malabsorptive issue, or if they didn't have enough cofactors, minerals, amino acids, if they're depleted, that wasn't the right thing to do. So we need to do an unprovoked test first, and then a provoked test and understand if chelation is appropriate for that patient. So I see a lot of chelation tests being run without looking at pre-provoked testing first. Yeah, I love that. I think to just to quickly explain to the audience, like provoked versus unprovoked. So unprovoked is really where you're, the body's at rest, you're running a blood test or whatever it is, and you're saying, what's flowing, what's floating around in the system when nothing's in your day to day. Whereas a provoked test is you're actually administering a compound that's going to actively push, hopefully, we hope, stored toxins, metals, whatever the case may be, out into the circulation where we can see them, because we know the body hides them. Is that a reasonable explanation for that? 100%. Yeah. Okay. Okay. There are some people, I expect a high mercury burden to eat a ton of fish, eat a lot of tuna. I test the blood, I test the urine, and it's not there. Or I test the blood, it's there, but it's not in the urine. And I go, wow, you're accumulating it, but you're not urinating it out, or it's not showing up. But I expect the burden. So then I start to think, what's going on downstream? You're not able to excrete any of this. You should have high metals. Okay. Maybe you have an issue with your glutathione. So then I want to understand their glutathione status. Is your glutathione oxidized? Is it under oxidized stress? If it is, then the rest of their body probably is under oxidative stress as well. So we need to fix that. Do they have enough glutathione? Do they have enough cofactors to support glutathione, specifically the B vitamins and magnesium and magnesium and selenium? Okay. I need to correct for the glutathione status first. Yeah. Yeah. So then we'll test. Yeah. No, that's one other little sidebar I wanted to bring in because a couple of years ago, I interviewed someone and one of the things that she talked about, I'm curious if you've seen this as well, is how you can do a panel for you know, the toxins, the co-infections, and you might only see one or two things. But what she talked about is when you remove that one or two, all of a sudden, it's like everybody was hiding behind them. Like they're, it's like the cyclists in a peloton, you got the guys that are coasting in the stream, the airstream behind the other guys, you don't see them, but they're there. And they may not even be active, but all of a sudden a space has opened up and now they like, are you seeing kind of this all the time, this expression of other stuff that comes up that you didn't even know was there? Yes, it comes with the, I expect it. If I don't see it, I'm surprised. If I don't see it, I'm like, well, we're going to see it. There's no way I haven't, I never see it not happen. Interesting. Okay, cool. Yeah. Yeah. All right. Pre-talks. Let's prepare the system. Talk to us about that. How like talks and talk to us about this pre-talks philosophy. Like what are you stabilizing before you mobilize those metals? Like, foremost, like, how does that all? It's really important that we, that we stabilize the bone loss first. First of all, we want to make sure the patient doesn't go into a diagnosis of osteopenia and osteoporosis because then that becomes dangerous. But I do want to keep that lead cemented in there for now. If they're still having a lot of bone turnover and losing the lead, I could chelate them. Fantastic, osteoporosis. So, with their money and their time and their health. So, we want to take care of the bone loss first. By working on the malabsorptive issues, by correcting for the hormones, by giving all the supplements. I don't like to give the bisphosphonase that they just lay down, you know, weaker bone. Yeah, yeah. So, usually I can correct for that. Then I'm, so then I'm looking at the cofactors against the nutrient status because if we start to chelate, but there's not enough nutrients, not only chelate, but maybe use phospholipids to pull out toxins from outside of the fat cells that would be maybe pulling out glyphosate or solvents or pesticides, phthalates. So, if I'm using phospholipid therapy to pull those toxins out of circulation, and I'm using EDTA and DMPS to pull metals out of the organ cells, but there's not enough minerals on board. Right. We're going to do a cellular detox, imagine here's a cell, there's the toxins in there, pull it out. Somebody's got to go there. I want them out flushed out of the system, not recirculated. They can get recirculated across the blood brain barrier then. So, I've had a lot of people say, I did a detox before and it felt horrible. I could only do that. Well, one day I would prepare you for that. It just means you weren't ready for that. So, it could have been ever depleted. But then I'm thinking about their organs each, or remember you talked about the emunteries a while ago. So, I'm looking at those emunteries. So, what's going on with the cut? If the patient is constipated, they've got chronic constipation. If I start to do a cellular detox, pulling toxins out of the cells and they're constipated, the toxins will just recirculate. If they have IBS or irritable bowel disease, they've got inflammation in their gut. This is not a time that I want to pull toxins out and have them rushed through the gut for deep detox. It's going to further inflame their gut. So, I want to provide for that. Or the liver. A lot of people have elevated liver enzymes. I want to bring them down with herbs, the liver bioregulator. I know why. It's high. The enzymes could be high because of the toxins themselves. So, as long as I'm supporting the liver through the process, then we can detox if they're ready for the kidneys. Chronic UTIs or interstitial cystitis. A lot of times interstitial cystitis is just mass-alertivation syndrome hitting the genitourinary tract. So, I want to correct for that before I start to detox because I don't want them peeing out toxins when that urine is filled with toxins. Going through that system. So, really supporting every system of their body, making sure lymphatic flow is adequate. I don't have a test for that, but we can tell when someone's lymphatics are stuck. I have people get lymphatic massage very, very gentle to start with while I'm supporting the other organs of the nation. The thyroid, the sex hormones, all of this has to be taken care of before we start to do a cellular detox. I love it. I love it. Okay. Well, and I would guess that doing that preparation is ultimately going to determine whether that detox is going to succeed or fail. I mean, I can only imagine. Like, if you haven't done all those steps, if you haven't taken care of all those things, that's when you're going to hit those walls or potentially end up with someone who feels worse than they did when they came in, which is really not the goal. The goal is when I'm like, please, doctors, don't do that detox. Don't do it. If all of this isn't taken care of, the patient will just be sicker. You talked a lot about how peptides fit into the process, especially for the immune support. What about mitochondrial support? Are you using, at any point in your process, are you using peptides to support mitochondria in these processes? I've been thinking a lot about this, actually. And talking to Dr. Navio about his work, the mitochondria, and in my clinical experience, I've seen it as well. The mitochondria, when they are experiencing insults, the insults I've talked about, multiple toxins, multiple infections, stress, diet, all of these issues, the mitochondria start to quieten down in their ATP production to be used for energy. So they stop using intracellular ATP instead. They send their ATP outside. It's called extracellular ATP. And that's the mitochondria ringing the alarm bell and telling the rest of the mitochondria, hey, we've got a problem here. We've got an insult. We've got to slow down, to contain the slowdown ATP production, increase oxidative stress, increase inflammation. The mitochondria do this. To contain the insult, people think of mitochondria as just ATP producers. But as you and I were talking about before we even got on there, they are, they're organelles that sense the environment. They speak to the immune system. They speak to the endocrine system. They're not just pumping out our energy. Not mildly, not blindly. That's for sure. They have a big job. They have a big job. And so I was telling Dr. Navio, I've noticed that when the patient is stuck in a state of persistent inflammation and persistent oxidative stress, if I start to stimulate the mitochondria, it's like tickling an angry person. They're not going to find that very funny. Right. So the mitochondria have, it's programmed, it's on purpose. They have quietened down their ATP production, but increased the oxidative stress to contain the insult. Now, a lot of these patients, we get rid of the insults. We clear the toxins. We kill the bugs. And they still are in a state of persistent oxidative stress and inflammation. It's still happening. They're stuck in the cell danger response. They're stuck in the response that they don't know how to quieten down. So this is a great time to bring in the peptides after. I've really thought in depth about sequencing. Do I want to use the peptides in? Well, I want to stop inappropriate apoptosis from happening. So I'm going to come in with human in first. Because human in, the mitochondria release that to tell the cells, it's time to stop that inappropriate apoptosis. So that one comes in first. Next, I'm going to bring in SS 31 because it's going to stabilize the inner mitochondrial membrane. When we stabilize the inner mitochondria membrane now, the mitochondrists can actually start to make more ATP. It actually stabilizes the electron transport chain and starts to bring down reactive oxygen species at the source. So remember when the person has those bugs, I want the mitochondria to increase their ROS. I want them to increase their inflammation. It's not that inflammation and reactive oxygen species is bad. It's bad at the wrong moment when it's stuck in a loop. The peptides get unstuck. That's a word. Stop that stuck pattern. It's breaking the loop. It's what you just said. It's really breaking the loop. Breaking the loop. And then I can bring in MoC. After, because that's about metabolic reprogramming. But if I bring in MoC before I bring in human in, it doesn't make sense to shift metabolic programming in cells that are inappropriately dying or doesn't make sense to ask the mitochondria to increase ATP after I've shifted the signaling. So that's how I like to think of it. So bringing in the end in this patient population. You're kind of understanding why is the mitochondria slowing down? And that is a respect for the innate wisdom in the body. That doesn't mean that sometimes we don't get stuck in loops. That doesn't mean that sometimes things go offline. But even for example, someone who's very, very stressed, one of the things I learned was, and we look at the thyroid and it's like, oh, the thyroid's not performing. So we try to boost thyroid function. But really that is because the adrenal glands are asking the thyroid to slow the heck down because they can't keep up with the demands. And here you're saying pretty much, a similar thing. And so what I think is important for us to sometimes understand is even though how we feel is like a bag of broken toys and we don't have energy and we can't move, if we can take a minute and pause and understand, is this something that the body is doing to somehow protect the rest of the system? And can we solve that first? And now we ask for more. You're going to get a better outcome because I think MOTC, it has this aura of just use MOTC, you're going to have more energy, you're going to burn more fat, you're going to perform better. Yes, but not if the system's already on its knees. That's a very powerful message, I think, that I hope lands with a lot of people. Okay, we're going to start winding down here. But I'm curious about your and I think, I believe I know what you're going to say, but for the audience, how do lifestyle tools like sauna, fasting, or exercise benefit or deplete? Again, where do you see them fitting in? Yeah, if somebody can tolerate the sauna, it's an excellent way of excreting metals. I mean, really any way of sweating, but the sauna gets deep, right? And yeah, sweating off those talks. But some of my patients can't be in the sauna for more than five or 10 minutes. Yeah. So if somebody has post exertional malaise, don't push yourself past that point, whether it's with exercise, whether it's with sauna, these things that are supposed to be good for you, they're not good for you anymore when your system is stuck in that loop, when you're depended, when your organs of elimination are not optimal, then this is only going to push you off the edge. For somebody who, you know, I've worked with them for maybe maybe it's going to take two years to get them better. And now they're through year one. And when they were sensitive to everything, they couldn't walk up a flight of stairs, they had to just take a deep breath after and then go to sleep the rest of the day. Of course, these people have to get checked out by the oligists, the proper cardiologist, pulmonary, whatever it is, they get checked out and they're within normal limits. The oligist says, you're normal. That's my blessing. I know I can go on what I need to do, right? But yeah, but I just have to throw that in there because it's important. 100%. Yeah. Right. But so these patients, they cannot tolerate anything. No sauna, no exercise, it's going to cause post exertional malaise. Just do what you can. But now say they're one you're in and they can walk up five flights of stairs now. But they still get a little tired instead of having to, instead of being bedridden, they just need a nap for an hour every day. At that point, you know, they can tolerate the sauna more, they can tolerate more exercise and they start to be more like a normal person and then patients see me and now I'm going to become a biohacker. I'm like, you go ahead, go do that. Yeah. What about these like binders with sauna? Because I think one of the things about sauna is, and especially in for, well, you know, there's some interesting literature that around infrared versus traditional sauna. And I know that the infrared can sometimes have real benefits for people who are more sensitive because they're not, their body's not being asked to ask to deal with as a high heat. And there was a really interesting study called the bun study, and it compared the differences in compounds that were released from the extreme heat versus the infrared, especially full spectrum, like it goes at different issues in different ways. But have you found, again, like, I mean, a population of people that can handle three minutes of sauna, that's just not for them. But if you found as that tolerance goes up, that using binders at the right time can kind of assist in kind of catching those toxins until the body can release them properly. Yes. I'm so glad you brought up binders. I want to bring up binders and peptides and how I use those together. There are many patients who cannot tolerate a binder. And they read books that talk about, but you have to use specific binders for specific clay, yeah, all this stuff. Yeah. Try all them. And it's not good. There's lots of people like that. They make them. I really think that's about the immune system. Just even thinking that the binder is is dangerous. So the way I use, they're talked about using peptides. That's it. Like, actually, I don't know if I don't, I'm bringing up another podcast. I don't know if, you know, if you saw Kent and I, Dr. Holthorpe and I doing a webinar together on on Sears, Chronic Confirmatory Response Syndrome. Yeah, he talks about that a lot. Yeah. And so, so binders, you know, they're not always going to work for people. They're not ready for it. So if we start to use the peptides to modulate the immune response, the way I was talking about earlier, people are going to start to eliminate toxins on their own. Their detox pathways are going to start to normalize when their immune system is in line. At that point, I might start to do more active detox with the patient. And at that point, they're actually more tolerant of the binders. Yeah, I love that you said that because I think binders get positioned as a, as a blanket solution for people. Oh, just take a binder. And I love that you're bringing up that there's real nuance and even in that space, because, you know, whether it's activated charcoal or bentonite clay, or there's some varied, there's some prescription ones that are, there's one in particular that I know people really like. Cholesteroamine, yeah, which is kind of like a good news, bad news thing. I think that, again, bringing nuance to that conversation and frankly, not even just for the complex chronic illness people, just for our run of the mill people is a really important distinction. So thank you for that. All right, let's, let's look ahead. And as we close up, I mean, you know, obviously we could keep going here. But what's in your, in terms of what you're seeing, what's the most exciting emerging science in environmental illness and longevity that you're seeing right now? Like, what's, what's on the horizon that really kind of floats your boat? Plasma for Rhesus. We actually, we actually do it at our clinic. So we have, we've been doing it for the past three, four years. For our patients or, or if people want to refer, we usually focus on people who have complex chronic illness, because that often allows us to remove enough toxin or enough oil antibodies to make room for us to do the other treatments that we need to do. The more toxins we are able to actually remove from the system, the more the immune system is going to start to modulate. Some people have such a high toxic burden that it's going to take years to detox. It's a little, the way I see it, it's a little bit, and maybe you could briefly explain what Plasma for Rhesus is, but just for people who may not have heard about it. But I think it's a little bit like in certain, not to go down the cancer road, but sometimes you just have to remove the tumor. Like sometime you just have to get rid of the physical, that physical piece so that you leave space for healing and, and everything else. And you know, maybe without the Plasma for Rhesus, it just would take so much longer, but you're able to kind of lower the levels on that bucket of toxins so that people can actually see a better benefit. So maybe quickly define for the audience, what is Plasma for Rhesus? Plasma for Rhesus is a technique where we pull out the toxins from the blood. Okay. And the toxins are, are, are stuck to albumin. Albumin is like a sponge for the toxins. So we pull it out and then we, we filter it. And then the fresh blood is introduced back into the system. So what gets filtered out? All kinds of toxins. So there is a paper done probably eight months ago now that showed that Total Plasma for Rhesus removes glyphosate, mycotoxins, metals, forever chemicals, a host of chemicals that it would otherwise take a long, long, long time to detoxify from. So then we replace the albumin and go ahead. Yeah. And also IG, IVIG. So Plasma for Rhesus, I, I'm thinking that that sounds more like Total Plasma Exgen-TP. It is. They're the same. Because I thought, oh, that's so interesting. Because I thought there were two different processes. So maybe I'm wrong about that. Because I thought Plasma for Rhesus was returning everything back, well, minus the bad actors, and that the TPE is where we replace albumin. So question about TPE, the, what are your thoughts on sourcing of albumin? Because I know that that is a real hot topic right now. And nobody asked, not a lot of people ask that question. So we've asked that question. We have. One question. And, and it is tested for. It is tested for, it's tested for. It is, it's clean. It's, it's important. So, so guys, just so you know, like what we're talking about here is, and this is a medical procedure, like this has been done in hospitals in very, you know, in very extreme cases for a long time. This is a, this is a pretty intrusive procedure. But I think what you're talking about is how powerful it can be in, in treating chronic complex illness where the load is just so high. And what do you think of people just running around getting TPE because it sounds like a good idea? I think there's too many of those, you know, I mean, some people, they say really help them. They feel differently. They didn't realize how fatigued they were, you know, but here's the thing. Getting TPE without having the appropriate support around that, I think that's inappropriate. I think it's not going to work as well. But we need to support, like I was talking about support the body with the amino acids, with the minerals. The more honestly prior, we'll give spermidine to help kill off the zombie cells. So we're going to support the body, pull it, we're going to do some cellular detox before giving the plasipheresis as well. Support the body in, in what we're asking it to do with the plasipheresis. After that, we are then supporting the body again. Some people might get NAD, they might get exosomes after it, right? They might get, they'll get more peptides after that because now we want to reprogram the cells. So plus this on its own without the support before and after, I don't think it's going to be as effective at all. Last question on this, even though this was supposed to be quick fire, is it one TPE or is it a series? It depends on the, on the person. So for somebody who is pretty well, they just want, they want to clear out zombie cells. They want to, they want to do this for anti-aging. Usually two is good and they could do in one month, they could do one another the second month or they could do one, one week and one another week in a row. For people who have complex chronic illness, they might need five or seven over the course of a year to a year and a half. Yeah, based on their tolerance, I would think. Yeah. And we go very, very slow. So the other clinics that, that do this, they go a lot faster, but we can't do that because our patients are sensitive. They're going to get really tired. They're going to have a mass cell reaction maybe. So if we run it really slow, maybe it's a five-hour process instead of a three-hour process. That's okay. We just want the person to be comfortable. Yeah, I love it. Okay. All right. Couple of quick questions and I'm going to release you to go back and heal the people. If you could rewrite the standard menopause conversation, what would change? What would you change about this standard menopause conversation that's happening? There's so much, there's good noise about it. It's good. There's a lot of attention. But what would you change about what's happening? I really want women to feel like they are self-sovereign, not only in their health, but in their lives and that their health is a reflection of their life, that women don't have to suffer. That's what I would change. We're taught, even though the message is starting to change, but for decades, it's been, hey, you don't have enough hormones. That's just aging. It doesn't have to be that we age unhealthily. There are many things that we can do to support that, and I'm all for it. Yeah. Well, and that ties into the next question. What gives you optimism about and about women aging well, despite the toxic world we live in? What gives you optimism? We have so many tools. Now, there are so many tools to even help with the nervous system, Amy Opakian's work, Captain King's work, the primal truss, like this is what women want. They're hungry for that internal healing. And that ties in with all the work that I do to shift their biochemistry, to work with their genes. But I'm doing more than that, that women will tell me everything. Yeah. What an honor. What an honor it is to hear the depths of our heart and soul, and when they're witnessed by their doctor who's working on their biochemistry, that's when they get to be seen as a whole person. And so that gives me hope. I love it. Dr. Nafisa, this has been a really wide ranging and fantastic conversation, which I knew it would be. So I want to thank you so much for being here today and for taking the time. And please let tell people where they can learn more about your work, about your amazing clinic. Yeah. So our clinic is Gordon Medical, and we're in the San Francisco Bay Area. And it's just gordonmedical.com. And there's information about me and all of our doctors at that on the website. So that's all there. And thank you. Thank you. Thank you so much. It's been a pleasure and an honor. And I look forward to many more conversations. Me too. Thank you so much. Hey, folks, just a quick reminder that all of the information presented in this podcast is for information purposes only. No medical advice, no diagnosing, no treatments suggested here. Before you try anything that you hear about or learn about here, make sure that you check with your medical provider.