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Dr. Deb Muth 0:03
Today’s guest is someone I’m honored to call both a friend and a mentor, and one of the most trusted voices in medicine for patients with complex chronic illness. Dr. Neal Nathan is a board certified family physician who has spent decades caring for patients who don’t fit neatly into diagnostic boxes. Patients with mold related illnesses, Lyme disease, mast cell activation, and profound nervous system dysregulation. These are the patients who are often told their labs are normal and their symptoms are anxiety or that nothing more can be done. Instead of dismissing them, Dr. Nathan listened and he asked better questions. His work, including his landmark book, Toxic, has helped thousands of people finally feel seen, believed, and understood, and more importantly, has given them a path forward when medicine failed them. This conversation is for anyone who reacts to supplements or medications, for anyone who has gotten worse instead of better with treatment, and for anyone who knows their body that something deeper is going on, even if they’ve been told otherwise. Dr. Nathan, I’m deeply grateful for your mentorship, your integrity, and the way you continue to advocate for the most vulnerable patients. I’m so glad to have you here today. And before we begin, grab a cup of coffee, tea, or whatever grounds you, because this is the conversation you’ll want to settle into. Now, before we go onto this conversation, we need to hear from our sponsors. So give us just a quick moment and then Dr. Nathan and I are going to dive in to his story and how this all started for him and leave you with some nuggets of wisdom that you can help yourself with. Ladies, it’s time to reignite your vitality. Primal Queen supplements are clean, powerful formulas made for women like you who want balance, strength, and energy that lasts. Get 25% off@primalqueen.com Serenity Health that’s PrimalQueen.com Serenity Health because every queen deserves to feel in her prime the right places and then we can get started. All right? So, Dr. Nathan, like I said, I’m so excited to have you here today. Tell us a little bit about how did you start your career? Because you didn’t intend to work with the most complex and sensitive patients, I’m sure when you started out. But what did you notice early on that made you realize medicine was missing something?
Neil Nathan MD3:03
You know, Deb, actually, I did start out wanting to work with the most complicated cases. My delusional fantasy when I started was I wanted to help every single person who walked into my office. And so when I left medical school, I realized pretty quickly that the tools that I learned there were not adequate to do That I needed to learn more. So I started on a passionate journey of discovery, if you will, in which I started studying with anyone who had anything interesting about healing to talk about. And I want to emphasize that I was interested in healing, not in what I’ll call medical technology. So medical school taught me to be a good medical technologist, but it didn’t teach me about healing. I graduated a long time ago. I graduated from Medical School in 1971. And the word holistic wasn’t even a word back in those days, but that’s what I was looking for over many, many years. I studied osteopathic manipulation, homeopathy, therapeutic touch, emotional release techniques, hypnosis. If it’s weird, I probably have studied it at some point. I wasted some weekends studying things that I don’t think were particularly valuable. And I’ve had some remarkable experiences with true healers that taught me how to expand my understanding of what healing really meant. So early on, when I first started practice, I would invite my colleagues to send me their most complicated patients because that was my learning. That makes me weird. I know that. I love some problem solving. You know, I’m the kind of person who I get up in the morning and I do all of the New York Times kinds of puzzles. That’s. That’s my brain wake up call. So actually I did invite my colleagues to send me their complicated patients, and they did. So, I mean, they were thrilled to have me in the community because these were people they didn’t know what to do with. And I was happy as a clam with all these complicated things that I had no idea what to do with. But it pushed me to keep learning more, to keep searching for this person’s answer. And this person’s answer, that constant question is, what am I missing? What is it that I don’t know or understand? What questions am I not asking this person that would help me to figure it out? So sorry for the long winded digression.
Dr. Deb Muth 6:14
No, I’m glad you shared that. I’m very similar to you. I didn’t seek out working with the most complex, but as I started that, I was always very curious as well. So I was the same as you. Every weekend I would learn something and hypnosis and naturopathic medicine, homeopathy, and all these quote unquote weird things, right? And there’s always a pearl that you learn from something. You never not learn anything, but some of it, you kind of take or leave or integrate or not. And, and I think it, it makes you a better Practitioner, because you have all these tools in your toolbox for helping people that nobody else has been able to help. And. And it’s just kind of fun learning. I mean, I’m kind of a geek that way too. I like to learn all those things.
Neil Nathan MD7:00
Learning is my passion. One of my greatest joys in life is going to a medical meeting and getting a pearl. Literally. I’m not one of these people at medical meetings that have a computer in front of me listening. And I have a pad of paper and I’m writing down ideas next to people that I’m working with. So that, oh, let’s bring this up for these people. Let’s bring this up for these people. So it’s like, oh, great. Can’t get right back to the office on Monday so I can start, have some new ideas about what I’m missing.
Dr. Deb Muth 7:38
Yeah, I do the same thing. I have my pad of paper and I do the same thing. And as I hear something, I’m thinking about a person that’s in my office that I haven’t been able to help, or we’ve been stuck on something, and I’m like, oh, there’s a new thing we can try. And it’s so exciting. I love that. Let me ask you this. Was there a time when you finally thought, like, if I don’t listen to these patients differently, they might not ever get better?
Neil Nathan MD8:04
That’s a very complicated question. The people that I was treating that weren’t getting better were the ones that got my greatest attention. And one of the questions that constantly troubled me still does is, is this person not getting better because of some feature of themselves, or is it because of something that I don’t know? So I’ve wrestled with that for a very long time. My answer to it now is, For a long time, I’ve been able to see what I will call the light in a person. Call it a healing spark and energy. It isn’t truly light. There’s just something about that person when I work with them where I know this person will get well if I stick with them long enough. And then when I don’t get that, I don’t think I’ve helped any of those people over the years. Yeah, so it was a very long process of really not helping people for five years daily. And I would. I would ask those patients, I would say, you know, I haven’t helped you. We’ve been doing this for a very long time. Why are you still here? And they would say, because you care. And I would. Back when I was Younger, that was enough for me to go. That’s true. Okay, I’ll keep working at it. But as I’ve gotten older, caring isn’t enough. It’s. I’m not sure I’m the right person for you. And so as I’ve gotten older, when I don’t see that spark, when I don’t get that sense of someone, I’m more inclined early on in the relationship to tell them I’m not the right person for you. Yeah, you know, see if you can find someone else who can understand what you’re going through and help you. Because I, I’m not it.
Dr. Deb Muth 10:16
Yeah, you, you kind of know that you can help them or not. Yeah.
Neil Nathan MD10:21
I don’t know how to define that sense, but it’s very clear to me. I call it like seeing the inner light of another being. If it’s not there, and maybe it’s not there for me to see as opposed to someone else can see it.
Dr. Deb Muth 10:41
That’s interesting. So you’re known for working with patients who are highly reactive. They don’t tolerate supplements, a lot of times medications, or even some of your most gentlest protocols. Why are these patients so often misunderstood?
Neil Nathan MD 10:59
Because they appear to their family and to many other physicians to be so sensitive that the thought process of families and other physicians is often. Nobody’s that sensitive. This has got to be in your head. And that is what is conveyed to those patients. And they’re told it’s gotta be in your head. Go see a psychiatrist or a therapist. But I can’t help you. And unfortunately, we have learned in the last 20 years a great deal about, is making our patients so sensitive. It is a true reaction of their nervous system and immune system, and it is in response to various medical conditions they have. So again, as we’ve been talking about, those were the people that got sent to me for many years. And I, I have never believed that the majority of any. Anything that someone has experienced is in their head. Yeah, Almost everything I look at is real. I may not understand what is causing it, but for me, doubting a patient’s experience is not something I’ve ever done. And that’s what’s helped fuel what I’ve learned and what you learned over the year. That, okay, if this is real, and it is, I’m sure it is, the person in front of me looks like a straight shooter. They’re not hyper reactive. They’re not going off the deep end talking about it and talking about it very straightforwardly. And I’ve got these symptoms. I’VE got this, I’ve got this. And it’s really making my life miserable. Okay, what’s causing that? So I began to work with what we now call very sensitive patients and figuring out what caused that. So over the years, I think we have names for this in medicine. Sometimes we call this multiple chemical sensitivity. People who will go to be walking down the street and someone will walk past them wearing a particular scent or perfume and they will literally fall to the ground or go brain dead or can’t think straight or even have some neurological symptoms. And I’ve seen that happen in my office. I’ve seen patients walking down the hall and having a staff member who had washed their clothes and tied walk past them. And I literally watched them fall on the floor. And it’s like, this is not psychological. This is someone who is reacting to the chemical that they are being exposed to and this is the effect it’s having on them. And so eventually it became clear that all forms of sensitivity, sensitivity to light, sound, chemicals, smells, food, EMFs, touch, were really being triggered by a limbic system that was unhappy. We began to learn about limbic issues before that. Give you a short history of it. I have discovered something called low dose immunotherapy different by Butch Schrader. And there was a long three year period of if someone stuck with it. If I used those materials over time, a lot of my chemically sensitive people would get better. It was the only tool I had back then.
Dr. Deb Muth 14:41
Yeah.
Neil Nathan MD 14:42)
Then, I don’t know, 15 years ago I discovered Annie Hopper’s work with dynamic neural retraining. And when I added that to what people were doing, that’s when I had my, ah, this is an Olympic system issue. And this is something we can reboot. And since then, many other people have limbic rebooting programs which are quite excellent and useful. Now I helped a lot of people at that point and it wasn’t until I stumbled on Stephen Porges work with the vagal system with this concept of polyvagal theory that I realized that the two areas of the brain that are monitoring that person’s environment, internal and external, for safety, are the limbic and the vagal systems combined. So when I started adding vagal strategies to the limbic strategies, I helped even more people. And then the first, the third piece of this trifecta was 2016 when Larry Afron wrote his book Don’t Never Bet Against Occam, in which he began our understanding of mast cell activation. And when I read his book, it was like, oh, big piece of the puzzle. And then we realized that those three things. And there’s more, but those three things were treated, Would help the vast majority of our sensitive patients regain their health and regain their equilibrium. This is not psychological. This is really treatable.
Dr. Deb Muth 16:19
Yeah, I’ve noticed the same thing in my practice and followed very similar paths. As you started out with ldi and lda, and then the vagus nerve things have been by far. I think if I look back, the vagus nerve work has been the biggest changer in our practice as well. I mean, all of the things help, but, like, I can give somebody a vagus nerve stimulator today, and within 30 days, 90% of their symptoms are better. And that just kind of blows my mind. It’s like I’ve never had a tool in my toolbox that has worked that well and that quickly. So. So it really is making a big difference. And I, too, was trained way back in the late 90s with multiple chemical sensitivity people. And some of those clients that I inherited from my mentor are still around. And, you know, they still can’t function at all. They’re wearing gas masks. They can’t leave their house. You know, any smells that even come in without them opening the windows, they are stuck. And no matter what you do, it’s just a challenge. Nothing works for them. And it’s a very sad life that they have to live.
Neil Nathan MD 17:30
Well, let’s add to that story that you can give people limbic vagal and mast cell treatments, and it’ll really work well to help them, but you need to look deeper, which is what is causing mass cell issues. And in my experience, mold toxicity is by far the number one and various components of lyme disease is a second one, and then a variety of other environmental toxins, infections, and things like that may trigger for some, but you’ve got to go back and get to the cause or else.
Dr. Deb Muth 18:12
Yeah, nothing works.
Neil Nathan MD 18:13
You can make them better, but you can’t really get them. Well, you get rid of the cause, and people can completely differently life back.
Dr. Deb Muth (18:20-18:21)
Yeah.
Neil Nathan MD 18:22
One of my frustrations with the mast cell world is after Larry efferent’s book came out, it changed people’s consciousness about mast cell activation. Something genetically rare to something which we now know. It affects 17% of the population, so not rare at all. But the clinics that are popping up to do it, and now in every major medical center of the country has a mast cell clinic. But number one, they rely completely on testing to make the diagnosis, and testing is notoriously inaccurate. And second, they just aren’t aware that you gotta get cause. So they’re helping people, but they’re not curing people because they’re not looking for cause.
Dr. Deb Muth 19:13
Yeah. And if they’re helping people, it’s on a minimal level, in my experience. They’re. You know, most of the patients that we see that have been at those clinics have been dismissed. Once again, told that because the testing isn’t positive and they’ve only done it once, that they don’t have this. But yet they fit all of the pictures. And then when you start digging, you start realizing they really do have mast cell, and. And you can find the answers for it for them.
Neil Nathan MD 19:40
Yeah.
Dr. Deb Muth 19:41
Why do you think mold remains so unrecognized in conventional medicine?
Neil Nathan MD 19:48
Interesting question. You know, I started writing a book chapter on the history of mold toxicity, our understanding of mold toxicity. And it’s. It’s fascinating to me. The mold toxicity is described in the Bible as a fairly long passage in Leviticus where it talks about that. So it’s not like it’s unknown to the universe, but largely, it’s remained undiscussed. Most people are aware of mold allergy. We’ve been treating mold allergy for decades. That we accept fully. I think the answer to your question lies in history a little bit. And I didn’t know this until I started kind of digging into it. There was an episode in the 70s in which a large number of school children in Cleveland, Ohio, got sick, and public health authorities attributed it to mold. About a year or two later, it was discovered that they. The H VAC system in the school had Legionella. Legionnaires disease. And it was then decided that, no, it wasn’t mold, it was legionnaires. And then a number of articles began appearing in the medical journals. Their names were literally mold. The hoax of mold toxicity. And that consciousness pervaded for 20, 30 years where people were reading these articles in which they were being told that mold toxicity was a hoax. That’s a strong word. And it took papers after papers after papers published in all kinds of medical journals, which were began to say, this is very real. This is symptoms that. That we see. It wasn’t until 2003, when Michael Gray and his team published a series of papers showing that these widespread symptoms, which we now recognize as mold toxicity, was real and directly attributed to mold. Now, keep in mind, we didn’t even have a test for mold at that point.
Dr. Deb Muth 22:10
Right.
Neil Nathan MD 22:12
So you could say this is mold toxin, because this person was. Well, they went into a moldy environment, they got sick, they went out of the moldy environment. They got well again, but we didn’t have treatments. We didn’t have a test for it. Historically, people were suspicious. Not very scientific. 2005, Richard Shoemaker wrote his book mole warriors, which really began to popularize the concept of this was a real thing. And in it, Ritchie talked about his markers and the visual contrast test. Now, these were not specific for mold, but they strongly, at least implicated that. Now, we had a test that could be helpful. So it wasn’t really until about 2010 that the first urine mycotoxin test came on the market. And at that point, we. We really could tell a person, you’ve got these symptoms, you’ve been living in mold. And now we have a test that shows you have mycotoxins in your urine. Now, it’s not like it’s a theory. It’s coming out of your body. That has furthered it, but not yet in the consciousness of the medical profession at large. As I’m sure you know, the history of medicine, in fact, the history of science, is that new ideas take 20 plus years to really be accepted by the profession. A new drug, a new technology is accepted very quickly because there’s an economic push to it. There’s no economic push to a new idea. So we’re still in the throes of some of us who work in the field. People say there’s no published data that really prove that this exists. And we’re working on that. As you know, we’re working on getting the papers published, but again, working on this history of molotoxism, There are actually hundreds and hundreds and hundreds of papers in the medical literature which really attest to the fact that this is a reality. It’s just that you and I are the only ones reading these papers.
Dr. Deb Muth 24:33
Yeah, we’re the only ones that care. Yeah. What would acknowledging mold actually forced medicine and the institutions to confront?
Neil Nathan MD 24:44
First of all, many medical offices and.
Dr. Deb Muth 24:47
Hospitals are molding, very much so.
Neil Nathan MD 24:51
And nobody wants to deal with that. It’s expensive. It’s difficult to truly get mold out of a building when it’s there. And so there’s a huge economic push to not acknowledge mold toxicity as an entity. The whole building industry doesn’t want to deal with it. Yes. It is estimated by the federal government that 47% of all molds have visible or smellable mold in them. It’s not like it’s rare. Not everyone’s going to get sick from it. But if your immune system takes a hit from anything and it loses containment over that mold, then you will take a hit from it. And it is also estimated that at least at this moment, 10 million Americans are suffering with some degree of mold toxicity and don’t even have a clue that that’s a real thing and that it can be both diagnosed and treated successfully.
Dr. Deb Muth 25:51
Yeah, it’s so hard. Like so many of the patients that we see, mold is never on their radar when they come to us. You know, Lyme disease is never on their radar when they come to us. And many of our patients have both. And the argument of there’s no way I could have, you know, mold exposure until you start digging back into their history a little bit. And then they’ll say, well, yeah, grandma’s house smelled and you know, I live in a hundred year old house, but it’s been completely renovated. And until you start having these conversations and really talking about it, people don’t have a clue that these things could make them sick. Or they, you know, I have a lot of clients that renovate houses for a living or that’s, you know, their hobby. And they go in and they renovate these houses and they’ve never worn appropriate equipment to protect themselves and, and then they’re sick 10, 15 years later. But don’t really understand why.
Neil Nathan MD 26:47
Yeah, from my perspective, it’s about how robust the immune system is.
Dr. Deb Muth 26:51
Yeah.
Neil Nathan MD 26:52
That if your immune system is robust, and this is true for Lyme as well as molecules, you could be bitten by a tick, you may have a Lyme or a co infection of Lyme like Bartonella rubesia in your body, or you could be exposed to mold, you could be living in a moldy environment, and your immune system will allow you to function at a high level for a while if your immune system takes a hit. Now the hit recently, big time, was Covid that unmasked Lyme and mold for a lot of people and a lot of people who think they have long whole Covid really have unmasked that they have Lyme and mold toxicity. That’s a whole other subject here. But menopause, childbirth, surgical procedure, any severe infection, any intense emotional reaction, death of a loved one, any of these can weaken the immune system. And then what is already there is no longer contained and we are off to the races of severely impaired health.
Dr. Deb Muth 28:02
Yeah, that’s what it did for me. I got sick with COVID and maybe about six, eight months later, I started to express neurological symptoms that looked like Ms. And actually had the diagnosis of Ms. But knowing what I know, I said, you know what? Ms. Is something else. Until proven otherwise in my book. And so because I had the knowledge that I did, I went and did all the Lyme testing and the mold testing and hit the trifecta of everything. Lyme co infections, mold, viruses. I just had everything. And as I started down that path of trying to clean it all up, all of my symptoms started to disappear. And certainly it wasn’t as easy as it sounds, and it wasn’t as quick. And I felt a lot worse before I felt better, as most of our clients do. But I think that I’m not the only person that this has happened to. And I think a lot of people get misdiagnosed just simply because nobody’s looking for the other problems that you and I look for and that we know of. And that’s one of the ways our medical system fails the clients they work with. Unfortunately.
Neil Nathan MD 29:12
One of the things that I teach and want people to be aware of is any specialist who makes the diagnosis that includes the word atypical. So atypical ms, atypical Parkinson’s, atypical Alzheimer’s, atypical rheumatoid arthritis, whatever it is, if that’s the word. What they’re saying is this has feedback features of this illness, but doesn’t really match what I see every day in my office. And when I hear the word atypical, I say, please look for mold, please look for Lyme. Because that is often the case here.
Dr. Deb Muth 29:51
Yeah, oftentimes it is. You also teach that when patients get worse under treatment, it doesn’t mean they’re failing. It means the treatment might not be appropriate for their psychology. Can you explain that a little bit?
Neil Nathan MD 30:05
Yeah. I think that many people start understanding about things like Lyme or mold and don’t really have the bigger picture. And so they will jump in with aggressive treatments in people who aren’t really ready for that degree of aggressive treatment. And here we’re going to come back to, if someone’s living vagal and mast cell systems are dysfunctional and not working properly, it is highly likely they won’t be able to take normal doses of the binders we use for mold, or to take antifungals or to take the antibiotics we need for Lyme disease. It’s not that they don’t want to. They can’t. And so what I see is not understanding what you need to do, in what order. If you do it in the right order, you’ll help the vast majority of people you’re working with. And again, that trifecta of limbic vaginal, mast Cell is one piece that a lot of people don’t address. And again, order matters. For example, in the mold world, some people have learned that, oh, I’ll need to give people antifungals to get this mold and Candida out of their body. But if you do that and you don’t have binders on board, there’s a very high risk that you’re going to cause a severe die off and make people really miserable. I remember when we kind of first started this, I was working with Joe Brewer, who’s an infectious disease specialist from Kansas City. And Joe wrote some of the earlier papers on this particular subject. And I was doing, I had a radio show at that point and Joe was on and we were talking about mold toxicity and how we treat it and what we did. And he mentioned that about 40% of his patients had this really nasty die off. And I went, I almost never see a die off. And so when we got off the program, we sat down and tried to compare notes about, okay, what am I doing differently than you, that I’m not getting the die off. And Joe, as an infectious disease specialist would go quickly to his antifungals. And yes, he put people on binders, but he also simultaneously put the lungs in pretty heavy doing antifungal. They got a nasty diure. I never put people in antifungals until their binders were up and running. So from my way of thinking about it, if you use any antifungal, they all work by punching holes in the cell wall of either a mold or a candida organism, killing it. However, by punching holes in it, what’s in that cell leaks out. And that includes mycotoxins. So. So you’re literally, if you’re using it aggressively, you can literally flood the body with mycotoxins. And if you don’t have the binders on board to mop it up, there’s a high risk that you’re gonna be pretty miserable. Cause you’re literally more toxic.
Dr. Deb Muth 33:18
Yeah, I remember in the early 2000s when they were teaching, if you’re not getting somebody to have that die off reaction, that quote unquote, herx reaction, then you’re not doing your job, you’re not giving them enough. And we would have clients that would come in and say, I’m not herxing. You’re not doing enough for me. And we were always the ones that are saying, you don’t have to hurt to get rid of this thing. I’m a naturopath too. And so preserving the adrenal Function was always very important to us. And we were like, if we cause you to hurts like that, now we’re depleting the adrenal system. We’re creating more problems that we’re gonna have to fix on the backside. And that was the narrative that was being taught back then. And I’m glad that’s not the narrative that’s being taught today, for sure. But people don’t understand. Like you said, you’re more toxic at this point, and creating more toxicity isn’t what we want to do.
Neil Nathan MD 34:12
It’s not good for healing. Kind of intuitively obvious, but you’re right. Back in the early days, we were taught that just to put a spin, I’ll call it on a nasty Herc’s reaction. Oh, great, we’re killing those little microbes. This is fabulous. Yep. I mean, that’s how we spun it back then. And currently I can’t say that some Lyme literate doctors still believe that, but most of us have realized that. No, that means we’re killing him too quickly. We need to modify what we’re doing so that we are killing it, but not at a rate that our patient is getting worse.
Dr. Deb Muth 34:59
Yeah, I always tell people we want to kill the bug, but we don’t want to make you feel like we’re killing you at the same time, because that’s what’s going to happen if we’re not careful. So, yeah, how does trauma and emotional or physical trauma and abuse and chronic illness, how do they all reinforce each other?
Neil Nathan MD 35:24
Our limbic systems have been trying to keep us safe since we were in our mother’s uterus. By again scrutinizing the stimuli we’re being exposed to from the perspective of safety. So none of us have had perfect childhoods. Yeah, some older than others. But depending on what you had in your childhood, maybe you had recurrent ear or throat infections and took lots of antibiotics. Or maybe you needed surgeries. Or maybe you had parents who were both working and not particularly available to you. Or maybe you had abusive parents in any way possible. But through your whole childhood experience, your limbic system is really going okay. This isn’t safe. This is not good for me. This is not right. And becoming more and more hyper vigilant to really be aware of that so it can try to keep us safe, which is okay. Maybe my parent was an alcoholic and okay, they’re coming in now. I’m going to make myself scarce. My limbic system is going to tell you, get out of here. Don’t put yourself in harm’s. Way, if that’s the case. And then as we go through our lives, more things occur. We have heartbreak when we’re teenagers, and we have difficulties with work or bosses or other things. Each insult of safety to us helps to create a limbic system that is more and more hypervigilant. So if you then have a trauma of any kind, it’s kind of like the straw that breaks the camel’s back at that point. And that could be mold toxicity, that could be Covid, that could be the loss of a loved one, that could be a betrayal of some point, any number of things, once that happens. Now that limbic system is super hypervigilant. Now, what that means is, symptomatically for people is we’re going to have symptoms in two main categories. Not to make us sick, but to warn us from our limbic system that, hey, this isn’t safe for you. You got to get into a safe place here. And those symptoms are in the category of emotion and sensitivity. So with any of our patients that we see, if they have become more and more anxious patients, panic, depressed, ocd, mood swings, depersonalization, derealization, that’s all limbic. And if they have any increase in sensitivity to light, sound, chemicals, smell, food, touch, EMFs, limbic. So most of our patients have gotten to that place. And as I’ve said, the vagal system comes along with the limbic system because it does the same job. Those symptoms are a little different. The vagal system controls the autonomic nervous system, and so things like temperature, dysregulation, pots, blood pressure, palpitations. The vagus nerve also controls almost all gastrointestinal function. So almost any symptom in the GI tract is going to have a vagal piece to it. Gas, bloating, distension, reflux, abdominal pain, constipation, diarrhea. So those are common symptoms in our patients. And it helps us to tease it apart that we can literally tell them these are symptoms of vagal dysfunction. These are symptoms of limbic dysfunction. And I hope I’m answering your question, which is, how does this evolve? It evolves throughout our whole life, and then eventually we get to the point where our limbic system is overwhelmed. And here’s the good news. We can treat this. We can fix it. We have various programs. And honestly, Deb, I believe that every man, woman and child on this planet needs limbic retraining, or at least limbic work. Co did a real number on the whole planet. Yeah, most people live in some degree of fear From a wide variety of causes. And we don’t have to live in fear. We don’t have to let us hurt us, but we do need to recognize that it is limbic, it is vagal, and we can do something about it.
Dr. Deb Muth 39:58
Yeah, that’s an exciting time for us, I think. You know, I. I agree. Like, the last couple of years have been very traumatic for a lot of people. Our young kids that were traumatized in school, their parents, the grandparents. I mean, everybody has gone through some kind of anxiety or fear around what’s happened in the last few years, and not to mention all the things that they’ve lived with their whole lives. And this just kind of came to a head and I think broke open for a lot of people that were suppressing their feelings up until this point. And it. It just was the perfect storm for a lot of people, unfortunately. And there’s a lot of people that can’t get over the trauma that’s occurred. The lying amongst the government and our families, how we treated each other and pushed each other aside and, you know, broken families apart because of their belief systems. It really did a number on people, and they’re really struggling to get back. Back for sure.
Neil Nathan MD 40:56
Yeah, we’re in complete agreement here.
Dr. Deb Muth 40:59
Yeah. Yeah. So many of our listeners, especially women, have been told their symptoms are anxiety or stress or quote, unquote, just hormonal. Right. And from your perspective, what damage does that kind of dismissal cause for people?
Neil Nathan MD 41:16
We have a fancy word for that, which is iatrogenic illness. Translation is your doctor is making you sick by treating you inappropriately, not making the right diagnosis and not honoring what you’re experiencing. There’s actually a new word that I’ve recently heard called medical gaslighting, in which you describe something to your doctor and he goes, no, this is in your head. There’s nothing really physically wrong with you, and you know that. No, no, no, no, no. I might be a little bit stressed by it, but something else is going on in my body. And they’re telling you, no, we tested you. Usually those testings involve doing a blood count and a chemistry profile, and that’s it. Those tests will not reveal the kinds of things we’re talking about because you’re not looking for the right thing. So it is really common for our patients to have been told that there’s nothing wrong with you. You need to see a psychiatrist because they don’t know enough to understand that the symptoms you’re describing, if you understood what you’re looking at, are very clear manifestations of Things. Things like mold toxicity and Lyme disease, chronic viral infections, a variety of other things. But your doctor has to know this in order to happen. And this is a failure of medical education. So if my message to everybody always is never doubt yourself or what you’re experiencing, it’s real, there’s never a reason to doubt that. If the people around you aren’t believing, you find someone who does. And again, to augment this, part of the problem is if families accompany the patient to the doctor’s office and they hear the doctor telling them it’s in their head, families become less supportive of their loved ones and go, well, doctor said, this is in your head. I don’t know why you feel so awful. And so families need the same point of view of trust your loved one’s perceptions. There’s no reason not to. Malaboring hypochondria is extremely rare. Gets talked about a lot. I’ve been practicing for over 50 years. I have rarely seen, seen anybody with those truly with those symptoms. So trust yourself. Good.
Dr. Deb Muth 44:03
I love that. What do you wish every clinician understood about listening?
Neil Nathan MD 44:13
I wish that every clinician had the same curiosity that we do, which is, I might not understand why this being in front of me has these symptoms or is ill, but I’m going to do everything in my power to figure it out. That means I’ll learn what I need to learn. I’ll study what I need to study to figure out why this person is sick. I really wish, and I understand kind of why that’s happened. My wife always thought that everyone was like me, which was Saturday mornings. My great joy in life was getting up early with a cup of coffee and reading medical journals or obscure medical books. That was my joy. She was shocked that most other people don’t. The way medicine actually evolved. We’re burning out doctors at a rate never before in the history of this planet by making them do things that are not in the service of patients, but are in the service of making money. And so doctors are being given seven minutes per visit. If you have a complicated person, there’s no way you could do income. Seven minutes. The way the system is set up, it doesn’t allow doctors to do their job. And then they’re under tremendous pressure to get the charts filled out properly, the way the advent of electronic medical records supposed to be. This great thing is it’s making doctors have to go home and spend two hours at home, not with their family, but getting their charts squared away. And I don’t think all patients realize the Kind of pressures that doctors are under. So to answer your question, I would like doctors to be more curious, but also, the system is broken, and I wish we could fix the system so that every patient could get the amount of time they needed with their doctor to really explore what’s going on and get to the heart of what’s happening.
Dr. Deb Muth 46:31
I so agree. So agree with all of that. If there was one question you would want every patient to ask their doctor, what would it be?
Neil Nathan MD 46:44
How would you treat me if I was your sister, mother, relative, whatever. Not what you want to do, theoretically. But if I were your wife, if I were your sister, how would you treat me? I don’t see that happening much, especially with elderly people. I see Doctors going, you’re 80. What do you expect me to do? I’m getting pretty close to being 80. And I expect you to help me because I want to function at this high level for a very long time. There was. It was an old joke that used to be Bella went in to see the doctor, and the doctor, he said, doc, my knee is all swollen and it’s tender and I’m having trouble walking on it. And the doctor said, you’re 102 years old. What do you expect? But, doctor, my other knee is perfectly fine, and it’s 102 years old also. So I once had the opportunity. I had a 100-year-old patient who had exactly that. So that was able to look at his knee and go, we’re going to take care of this. So it’s just older people need to be treated with respect, with the same thing, of absolutely no reason that they shouldn’t get the kind of attention that you would want your grandfather, your father, to have.
Dr. Deb Muth 48:16
Yeah, I love that question. So I have one last big question for you. If medicine were rebuilt around patients instead of systems, what would you change? First.
Neil Nathan MD 48:33
I would get rid of the middle man in medicine, the HMOs, the managed care organizations, where they take the profit and it’s being shunted into other areas. So rather than the physician being paid directly for what’s happening, they just get a piece of it that the managed care organization deems appropriate. You know, I grew up in what was called golden age of medicine back in the 70s, where I could do for people what they wanted done. People didn’t doubt that it was in their best interest and that if I ordered a test, it got done. I didn’t have to have someone else authorizing or tell me this is an okay or an appropriate test, I could do it. So I would go back to a. A practice of medicine, direct care, where you. Maybe there’s a system that would help reimburse you for it, but you could go to the doctor and you get what you need, and the doctor decides what you need. Actually, they’re the ones seeing you. Would a clerk in an office 600 miles away decide whether you can have this test or not? Have this test? Test? It doesn’t make any sense to me. I should be able to deliver what you want and need, and I should have the time it takes to really work with you. I’d like to go back to the 70s.
Dr. Deb Muth 50:07
Me too. Me too. Is there one thing that gives you hope right now for our system?
Neil Nathan MD 50:16
Honestly, I’m a very optimistic person. My answer is is no. I think the system is broken. I think it is being held intact by people who are profiting from this system. They have no interest in letting go of their profits for it, and they don’t have any interest in seeing that people get treated properly and well. So I think, as I said, the system’s broken. It needs to be rebuilt from the ground up.
Dr. Deb Muth 50:45
I agree. I agree. Dr. Nathan, thank you so much. Not just for the conversation, but for the way you’ve modeled curiosity and humility and compassion in medicine. It is an honor to work alongside of you, call you my friend, and learn from you. Thank you so much for that. For those listening, if this episode resonates with you, I want you to hear this clear clearly, your sensitivity is not a flaw. Your body is not broken. And needing a different approach does not mean you’re failing. Healing doesn’t happen by forcing the body. It happens when the body finally feels safe enough to heal. If this conversation has helped you and you feel seen, I encourage you to share it with someone who needs that as a reminder. Thank you for being here and thank you for sharing with us. Let’s talk wellness now.
Neil Nathan MD 51:38
So in this context, I just want people to be aware of one of my recent books, which is the Sensitive Patient’s Healing Guide, which talks about this in great detail. And the new second edition of my book, Toxic, goes over the whole mold Lyme thing in more detail. So again, that wasn’t intended to be self serving, but rather there are resources where you can learn even more about it than Deb and I are able to cover in this short interview.
Dr. Deb Muth 52:09
Yeah, absolutely. And your first book, Toxic, was amazing. So if people haven’t read it, you definitely want to read the second version of it because it is incredible. And Dr. Nathan, if there’s somebody that wants to get a hold of you. How do they find you? How do they learn more about what you’re doing?
Neil Nathan MD 52:24
A very complicated website. Neilnathanmd. Com.
Dr. Deb Muth 52:30
Perfect. Well, thank you for today.
Neil Nathan MD 52:34
You’re very welcome.