Latest / Resiliency Radio with Dr. Jill Carnahan, MD / 339: Resiliency Radio with Dr. Jill: TPE: Myths and Facts with Dr. Nafysa Parpia & Dr. Eric Gordon

Transcript

339: Resiliency Radio with Dr. Jill: TPE: Myths and Facts with Dr. Nafysa Parpia & Dr. Eric Gordon · Resiliency Radio with Dr. Jill Carnahan, MD

• 0:02
  Dr. Jill Carnahan: Welcome to Resiliency Radio, your go to podcast for the most cutting edge insights integrative and functional medicine.
• 0:09
  Dr. Jill Carnahan: I'm your host, Dr. Jill, and with each episode we dive into the heart of healing and personal transformation.
• 0:16
  Dr. Jill Carnahan: Join me as I interview medical experts, world leaders, innovators of all types, helping you on your journey to optimal healing and performance.
• 0:24
  Dr. Jill Carnahan: Today I have two special guests and friends from the Gordon Medical Clinic.
• 0:28
  Dr. Jill Carnahan: I'll introduce them in just a moment.
• 0:30
  Dr. Jill Carnahan: And our topic today is tpe.
• 0:32
  Dr. Jill Carnahan: If you haven't heard of that, we now offer that in our clinic.
• 0:35
  Dr. Jill Carnahan: You can learn more about that if this podcast episode interests you.
• 0:40
  Dr. Jill Carnahan: At MD Lifespan, Dr. Jill, you can see my mold protocol and also many of the other protocols we've developed.
• 0:47
  Dr. Jill Carnahan: You can actually get more information there and you can book a free consult with one of the doctors that will be helping you through your case.
• 0:55
  Dr. Jill Carnahan: So if you want more information about TPE, especially after listening to this episode, go to MD Lifespan.
• 1:01
  Dr. Jill Carnahan: DoctorJill check it out.
• 1:03
  Dr. Jill Carnahan: Okay.
• 1:03
  Dr. Jill Carnahan: I also want to remind you that if you have not checked out the retail store drjilltalk.com we have so many incredible products and services to help you on your way to health and healing.
• 1:13
  Dr. Jill Carnahan: One of the topics you'll hear in this episode is peptides and we even have peptides available for you.
• 1:19
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• 1:20
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• 1:26
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• 1:31
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• 1:35
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• 1:43
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• 1:44
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• 1:44
  Dr. Jill Carnahan: Mellow brightoctorjill health.com okay, now let's get to our show and introduce our guests.
• 1:51
  Dr. Jill Carnahan: We have two guests today, Dr. Nafisa Parfia.
• 1:54
  Dr. Jill Carnahan: She's a board certified naturopathic doctor and director of Naturopathic Medicine at Gordon Medical, specializing in complex chronic illness including Lyme and T disease, mold related illnesses, autoimmune, fibromyalgia, long Covid ME CFS and mast cell activation syndrome.
• 2:09
  Dr. Jill Carnahan: That's a mouthful, isn't it?
• 2:11
  Dr. Jill Carnahan: She's a recognized expert in peptide therapy and combines advanced testing with personalized treatment plans, integrating functional and conventional medicine, regenerative treatment and many other things.
• 2:20
  Dr. Jill Carnahan: You're going to love her today.
• 2:21
  Dr. Jill Carnahan: And Dr. Gordon is an internationally recognized expert in complex chronic illness as well, with more than 45 years of clinical expertise, treating many, as I just mentioned, autoimmunity, mitochondrial dysfunction, me, cfs, Lyme disease, so many more that I could mention.
• 2:37
  Dr. Jill Carnahan: But I want to get them on the show so we can get right to it and talk about tpe.
• 2:41
  Dr. Jill Carnahan: So let's welcome them to the show.
• 2:44
  Dr. Jill Carnahan: Hello, everyone.
• 2:45
  Dr. Jill Carnahan: So glad to be here with two of my favorite friends and colleagues, Eric and Nafisa.
• 2:50
  Dr. Jill Carnahan: And we are going to talk today about a topic that's becoming much more popular.
• 2:55
  Dr. Jill Carnahan: Many of you have heard a little bit about it if you've been around me, but if you haven't, we're going to dive deep into tpe, therapeutic plasma exchange.
• 3:03
  Dr. Jill Carnahan: If you don't know what that is, stay tuned.
• 3:05
  Dr. Jill Carnahan: I promise it'll be worth your while because this is an up and coming, it's kind of an old, new therapy.
• 3:10
  Dr. Jill Carnahan: It's actually been around a very long time.
• 3:13
  Dr. Jill Carnahan: And we're going to talk about busting the myths and talking about the facts around this therapy and how it can be especially helpful in the populations that we all serve, which is those of you with complex, chronic, mysterious types of illnesses.
• 3:26
  Dr. Jill Carnahan: And as I mentioned in the beginning here, I think it's so important those of you listening, if you have friends, family, yourselves that are struggling with mysterious illnesses, stay tuned because we're going to talk about that.
• 3:36
  Dr. Jill Carnahan: We're going to talk about a framework and we're going to especially be talking about tpe.
• 3:41
  Dr. Jill Carnahan: So welcome to the show.
• 3:42
  Dr. Jill Carnahan: So glad to have you both here.
• 3:44
  Dr. Nafysa Parpia: So glad to be here.
• 3:45
  Dr. Nafysa Parpia: Thank you, Jill.
• 3:46
  Dr. Eric Gordon: Always a pleasure, Jill.
• 3:47
  Dr. Nafysa Parpia: Yeah.
• 3:48
  Dr. Jill Carnahan: Yes.
• 3:48
  Dr. Jill Carnahan: You're welcome.
• 3:49
  Dr. Jill Carnahan: And I feel the same.
• 3:50
  Dr. Jill Carnahan: We talked right before we got on to just how in this world of functional, integrative, personalized precision, we could give all these names, optimal performance, longevity medicine.
• 3:59
  Dr. Jill Carnahan: It is such a treat to talk to colleagues that really get it.
• 4:02
  Dr. Jill Carnahan: And I hold you guys in high regard in regards to how you view the map of illness and how we look at patients.
• 4:09
  Dr. Jill Carnahan: And maybe before we dive into tpe, let's just start there and talk a little bit about you guys have both treated.
• 4:16
  Dr. Jill Carnahan: And forgive me, you guys is an old term, I should retire, but I'm still used to that slang.
• 4:20
  Dr. Jill Carnahan: Right.
• 4:21
  Dr. Jill Carnahan: You both respectfully have treated some of the most complex patients in medicine.
• 4:27
  Dr. Jill Carnahan: What have these patients taught you about how to map out what you're seeing in clinical practice?
• 4:37
  Dr. Eric Gordon: I think probably the most important thing is that in chronic illness, it's not the cause that is the main driver Usually, I mean, you know, everybody looks for the cause.
• 4:53
  Dr. Eric Gordon: And these days people are starting with mast cell and mold and, you know, then go down the list and.
• 5:00
  Dr. Eric Gordon: But at the end of the day.
• 5:01
  Dr. Eric Gordon: And that works fine for people who are fairly robust.
• 5:06
  Dr. Eric Gordon: But if they've been sick for long enough, what we're dealing with is the compensations that the body has made.
• 5:14
  Dr. Eric Gordon: So it's.
• 5:15
  Dr. Eric Gordon: And in medicine, we're always looking for the thing that's broken.
• 5:19
  Dr. Eric Gordon: But in these people, generally you have a series, like five or 10 systems that are just working suboptimally and as well as, you know, the big quote, unquote triggers.
• 5:33
  Dr. Eric Gordon: And so.
• 5:34
  Dr. Eric Gordon: And if you try to deal with the triggers right off the big things, people often get worse.
• 5:40
  Dr. Eric Gordon: And so we have to in.
• 5:41
  Dr. Eric Gordon: And again, there's no harm.
• 5:43
  Dr. Eric Gordon: I shouldn't say there's no harm, but when people are first ill, going after the big.
• 5:48
  Dr. Eric Gordon: The big things are probably the right way to go.
• 5:51
  Dr. Eric Gordon: You know, there's no harm in treating Lyme disease or, you know, treating, you know, chronic infections.
• 6:00
  Dr. Eric Gordon: But in most of the chronically ill people, you know, they have on top, they usually become mold sensitive or their mast cells are now activated.
• 6:10
  Dr. Eric Gordon: And so those have to be dealt with.
• 6:11
  Dr. Eric Gordon: And I'm going to.
• 6:12
  Dr. Eric Gordon: But underneath it all is a toxicity.
• 6:15
  Dr. Eric Gordon: And that's where I think maybe let Nafisa talk more about and then we'll come back to.
• 6:21
  Dr. Eric Gordon: What I'm talking about is compensations.
• 6:22
  Dr. Nafysa Parpia: You know, before we go to talk about toxicity.
• 6:26
  Dr. Nafysa Parpia: I think about it this way, that there are five main reasons people get sick with complex chronic illness.
• 6:33
  Dr. Nafysa Parpia: Not acute illnesses, but persistent chronic infections, environmental toxins, stresses.
• 6:43
  Dr. Nafysa Parpia: And a lot of people have had adverse childhood events or personal stresses.
• 6:47
  Dr. Nafysa Parpia: They're going through at the same time, diet and lifestyle and their genes.
• 6:54
  Dr. Nafysa Parpia: And when people have the first four going on persistently, they get persistent inflammation, persistent oxidative stress, and they get stuck in this loop of those two things.
• 7:05
  Dr. Nafysa Parpia: And now we have persistent inflammation, oxidative stress, meeting the genes, meeting the different systems of the body.
• 7:13
  Dr. Nafysa Parpia: And now we have these secondary downstream illnesses.
• 7:17
  Dr. Nafysa Parpia: And what I found is that when we're working, when we work with the systems first, the downstream issues first, I'll call that mast cell activation syndrome.
• 7:27
  Dr. Nafysa Parpia: I'll call that autoimmunity, call that endocrine disruption, sibo, leaky gut.
• 7:36
  Dr. Nafysa Parpia: When we can deal with these, which have really, these things have become, I would say, the ultimate root cause of chronic illness because we've got this persistent inflammation, oxidative stress, and we've got to calm that down that penultimate cause of chronic illness and then reach for the root causes.
• 7:57
  Dr. Nafysa Parpia: Because as Eric was saying, if you try to kill the infections or the toxins first, they can't handle it.
• 8:02
  Dr. Nafysa Parpia: But I say it's because inflammation, oxidative stress, it comes with the territory.
• 8:07
  Dr. Nafysa Parpia: When we're going to kill infections, persistent infections, and detox people, we're going to increase inflammation, we're going to increase oxidative stress.
• 8:15
  Dr. Nafysa Parpia: Their bucket is already to the limit, maxed out with those things.
• 8:20
  Dr. Nafysa Parpia: So I want to calm those systems first, the secondary downstream effects first, and then come in and deal with the causes.
• 8:30
  Dr. Nafysa Parpia: And when Eric talks about compensations, that's, that's also what I'm talking about, the secondary downstream things.
• 8:37
  Dr. Nafysa Parpia: So I just wanted to say a little bit about that.
• 8:40
  Dr. Nafysa Parpia: But about environmental toxins, they sure are higher now than they ever were before.
• 8:47
  Dr. Nafysa Parpia: And we see a high load of environmental toxins in these patients.
• 8:53
  Dr. Nafysa Parpia: So what patients, diagnoses like me, cfs, long Covid, chronic Lyme autoimmune conditions, fibromyalgia, environmental toxins are a big piece of that contribution to persistent inflammation and oxidative stress.
• 9:09
  Dr. Nafysa Parpia: And very often we need to detoxify them.
• 9:14
  Dr. Nafysa Parpia: And we're coming in often, when needed, in the right patient, tpe.
• 9:19
  Dr. Nafysa Parpia: And so I'd love for you to bring that up.
• 9:22
  Dr. Eric Gordon: Yeah, I think even before I go to tpe, what you brought up was the gut.
• 9:27
  Dr. Eric Gordon: You know, I mean, everybody's, We've all been dancing around the gut forever, you know, and in the old days it was easier because we didn't have as much information.
• 9:36
  Dr. Eric Gordon: We, we got, you know, we got test results on, you know, 10 bugs, and now we get hundreds.
• 9:42
  Dr. Eric Gordon: So there's a lot of learning there.
• 9:44
  Dr. Eric Gordon: But, yeah, but the, the gut, because once the gut gets inflamed, okay, you wind up in this situation where you're no longer absorbing nutrients like you should, and then, and you're stressing your liver.
• 10:02
  Dr. Eric Gordon: And so then that detox part is no longer a nothing or a mild headache or not feeling well.
• 10:11
  Dr. Eric Gordon: But people get really sick because the liver has been working too hard.
• 10:16
  Dr. Eric Gordon: Because remember, everything that happens in the gut, all that blood gets drained into the liver.
• 10:22
  Dr. Eric Gordon: And that's what the liver has to deal with.
• 10:24
  Dr. Eric Gordon: And when it's full.
• 10:28
  Dr. Eric Gordon: It has to, it's one of your main detoxification organs.
• 10:32
  Dr. Eric Gordon: And once it's up to the top, it really doesn't do well.
• 10:35
  Dr. Jill Carnahan: It's almost like we could have the liver metaphor be the bucket.
• 10:38
  Dr. Jill Carnahan: I want to just restate what you've stated so that our audience who hears this clearly, because you guys have done such a great job of like this overview and kind of shifting people's thinking from just like, oh my gosh, I have Lyme disease.
• 10:48
  Dr. Jill Carnahan: Oh, I have mast cell.
• 10:49
  Dr. Jill Carnahan: And as you know so well, our social media platforms are a bust of whatever we're hearing or talking about.
• 10:54
  Dr. Jill Carnahan: And then we get those things.
• 10:55
  Dr. Jill Carnahan: And I'm always little disheartened by the kinds of things that are out there that are misinformation and from people who have no real credentials at all to be speaking.
• 11:03
  Dr. Jill Carnahan: I cured myself from this.
• 11:04
  Dr. Jill Carnahan: And so I'm the expert and I kind of cringe just a little because there's a lot of misinformation out there.
• 11:10
  Dr. Jill Carnahan: So I want to talk about tpe, but before we do, I want to lay this groundwork.
• 11:13
  Dr. Jill Carnahan: Nafisa, you said this, these five things, you gave us a really clear map of all the different things that are interplay.
• 11:20
  Dr. Jill Carnahan: And rather than focus on just a diagnosis or name or ICD10 code, which could be vector borne illness like borrelia or mold related toxicity, or mast cell activation, which are all common popular things, it's more this underlying terrain that all comes with the mix of things.
• 11:38
  Dr. Jill Carnahan: And then Eric, you said that this is, it's important to really calm down that first and think about this gut immune interface as really a core piece.
• 11:52
  Dr. Jill Carnahan: I would love to frame that as just real quickly.
• 11:54
  Dr. Jill Carnahan: Toxic load is so big, all of us see it every day.
• 11:57
  Dr. Jill Carnahan: And I think one thing that you were mentioning, Eric, that people don't understand is we think of toxins from the outside, right?
• 12:02
  Dr. Jill Carnahan: The air that we breathe, the water that we drink, metals, pfas, parabens, phthalates, mold.
• 12:08
  Dr. Jill Carnahan: But what you're talking about, Eric, really importantly is these endotoxins which come from inside out and could be just as big of a load.
• 12:15
  Dr. Jill Carnahan: Do either one you want to talk a little bit about?
• 12:17
  Dr. Jill Carnahan: Because I think this is so important to, for people to realize they're getting toxic from the inside of their gut is a mess.
• 12:23
  Dr. Jill Carnahan: Right?
• 12:23
  Dr. Jill Carnahan: Hey guys.
• 12:24
  Dr. Jill Carnahan: Interrupting the show for just a quick moment to let you know that if you're looking for therapeutic plasma exchange, I don't know if you knew this or not, but we offer therapeutic plasma exchange in my clinic in Louisville, Colorado.
• 12:36
  Dr. Jill Carnahan: So you.
• 12:36
  Dr. Jill Carnahan: If you're in the state of Colorado or anywhere in the area and looking for a great provider, we contract with a group called MD Lifespan, one of the national leaders in offering therapeutic plasma exchange.
• 12:49
  Dr. Jill Carnahan: We have protocols for brain health, immune system, cardiovascular, prenatal preconception, mold related illness, which of course I've helped to create the protocols there.
• 12:59
  Dr. Jill Carnahan: And really anything you could want or need, these are highly effective protocols.
• 13:04
  Dr. Jill Carnahan: And I would love for you to get more information or schedule a free call with one of our physicians at MD Lifespan, Dr. Jill.
• 13:13
  Dr. Jill Carnahan: So go to MD Lifespan, Dr. Jill, check it out.
• 13:17
  Dr. Jill Carnahan: And let's get back to our show for more about tpe.
• 13:21
  Dr. Eric Gordon: You know, the toxicity from the gut has always focused on the lipopolysaccharides.
• 13:26
  Dr. Eric Gordon: These are like part of the cell membranes of gram negative bugs, which your body is really primed to protect you from, because that's how people died from sepsis up until the last hundred years of antibiotics.
• 13:39
  Dr. Eric Gordon: That's how we usually died.
• 13:41
  Dr. Eric Gordon: And most often it was very common that the gram negatives were the things that got us.
• 13:48
  Dr. Eric Gordon: And so your body is really sensitive to that.
• 13:51
  Dr. Eric Gordon: And one way to start getting inflammatory cytokines going is to have a leaky gut where this lipopolysaccharide gets across into the bloodstream.
• 14:02
  Dr. Eric Gordon: And you know, these are comparatively low doses, but they're enough to activate a very sensitive system.
• 14:09
  Dr. Eric Gordon: So that keeps people chronically inflamed.
• 14:12
  Dr. Eric Gordon: But on top of that, there are many other chemicals.
• 14:14
  Dr. Eric Gordon: And I've been working for the last year a lot with this fellow, Joshua Lees, who has, I think, a very good framework or way of looking at things, treat a little differently than he does, but I think it's a very good framework.
• 14:30
  Dr. Eric Gordon: And he focuses a lot on what happens once the gut gets inflamed.
• 14:35
  Dr. Eric Gordon: That you have a hormone called hepcidin that's made in the liver that is designed to protect you again from acute infection.
• 14:44
  Dr. Eric Gordon: Because what it does is it shuts down the mineral transport.
• 14:48
  Dr. Eric Gordon: This should be like everything else we talk about that keeps us ill.
• 14:53
  Dr. Eric Gordon: This should be a transient immune effect that is gone within three, five days, three weeks.
• 15:01
  Dr. Eric Gordon: Not long term, because it's designed to keep you alive and to keep the bugs from reproducing because the bugs need these minerals.
• 15:09
  Dr. Eric Gordon: And so when you have bugs in your bloodstream, you want to stop them as fast as you can.
• 15:14
  Dr. Eric Gordon: So you shut down minerals that are available and so you stop absorbing them and you also lock them into your cells.
• 15:22
  Dr. Eric Gordon: But if you keep doing that, over.
• 15:24
  Dr. Nafysa Parpia: Time,.
• 15:26
  Dr. Eric Gordon: Over time, your trace minerals will begin to diminish.
• 15:31
  Dr. Eric Gordon: And remember, all your vitamins, all your B vitamins have cofactors that are minerals.
• 15:38
  Dr. Eric Gordon: Think of B12 is East Cobalt, but they all need B6.
• 15:42
  Dr. Eric Gordon: Doesn't get activated.
• 15:44
  Dr. Eric Gordon: Doesn't really get into the cell into the active form of P5P until you've got magnesium and zinc.
• 15:51
  Dr. Eric Gordon: You need these.
• 15:53
  Dr. Eric Gordon: They begin to diminish over time with chronic inflammation.
• 15:58
  Dr. Eric Gordon: It's very important.
• 16:00
  Dr. Eric Gordon: Also this also locks in the heavy metals into the cells so you get hurt both ways.
• 16:08
  Dr. Jill Carnahan: A trapdoor is stuck.
• 16:10
  Dr. Eric Gordon: It's stuck.
• 16:11
  Dr. Eric Gordon: Yeah.
• 16:11
  Dr. Eric Gordon: And your body's usually.
• 16:13
  Dr. Eric Gordon: I mean that's the other reason heavy metals are such a big deal.
• 16:15
  Dr. Eric Gordon: Didn't go through all the toxins, but that's ones that we've all known about for years and we all tried to deal with.
• 16:21
  Dr. Eric Gordon: But this is one of the reasons they keep building up in our patients.
• 16:25
  Dr. Eric Gordon: It's not just that their glutathione is low, but it's also that the body has stopped excreting them from the cells.
• 16:34
  Dr. Eric Gordon: When you have this constant inflammatory signal going.
• 16:38
  Dr. Eric Gordon: So long story but very important little side piece and also fascinating, I think.
• 16:44
  Dr. Jill Carnahan: So, so important.
• 16:44
  Dr. Jill Carnahan: I love these tangents because they're critical and fire a lot of people listening.
• 16:48
  Dr. Jill Carnahan: I'm sure it's kind of new.
• 16:49
  Dr. Jill Carnahan: One just question I have practically is I have found incredible power in very simple mineral adding back.
• 16:56
  Dr. Jill Carnahan: Right.
• 16:57
  Dr. Jill Carnahan: Like liquid minerals in different forms.
• 16:58
  Dr. Jill Carnahan: I could name brands.
• 16:59
  Dr. Jill Carnahan: I won't but I'd love to know some of your favorites if you want.
• 17:02
  Dr. Jill Carnahan: But I feel like that's very simple.
• 17:05
  Dr. Jill Carnahan: Very like most of my patients are on liquid minerals of some type.
• 17:08
  Dr. Jill Carnahan: Have you guys found that because of this?
• 17:11
  Dr. Nafysa Parpia: Absolutely.
• 17:12
  Dr. Eric Gordon: It's something I learned from Nafisa when she first joined us about 10 years ago.
• 17:17
  Dr. Eric Gordon: You know, being.
• 17:19
  Dr. Eric Gordon: It was, you know, the basic naturopathic and you know, Dr. Paul's teachings for 30 years was how important the trace minerals were with all those people who would take glutathione and get headaches and feel terrible.
• 17:32
  Dr. Eric Gordon: And it's just if they don't have trace minerals, they can't metabolize it.
• 17:36
  Dr. Eric Gordon: You can't regenerate your glutathione.
• 17:40
  Dr. Eric Gordon: That was one of the watching how she was using IVs in a much more creative way than I had been over the years.
• 17:49
  Dr. Eric Gordon: Because we'd always talked about detox.
• 17:51
  Dr. Eric Gordon: But being medical doctors and not naturopaths, sometimes it was more lip service than real.
• 17:59
  Dr. Eric Gordon: We would throw detox.
• 18:03
  Dr. Eric Gordon: That's been the biggest lesson of working together, I think for me has been when you actually handle the basics, the body can really start doing the rest.
• 18:18
  Dr. Jill Carnahan: Super important.
• 18:19
  Dr. Jill Carnahan: And I love that because I feel the same.
• 18:20
  Dr. Jill Carnahan: I always say I learned most of my really Cool skills from naturopathic doctors.
• 18:24
  Dr. Jill Carnahan: Because the same way you guys really know all of the ways of lymph and the circulation and all the things that we never were taught deeply in medical training.
• 18:34
  Dr. Jill Carnahan: So I love that.
• 18:35
  Dr. Jill Carnahan: Let's do this.
• 18:36
  Dr. Jill Carnahan: I know you guys are so good at detox and Nafisa, you're one of the queens of detox and pre tox and all of that.
• 18:41
  Dr. Jill Carnahan: We talked about our last episode.
• 18:42
  Dr. Jill Carnahan: Episode.
• 18:42
  Dr. Jill Carnahan: We'll link that up if you guys haven't seen that one.
• 18:44
  Dr. Jill Carnahan: But I want to start before we go into tpe.
• 18:46
  Dr. Jill Carnahan: I promise, guys, we're coming to that.
• 18:48
  Dr. Jill Carnahan: Next, give us just basics 101 on detox.
• 18:51
  Dr. Jill Carnahan: What would patients want to do?
• 18:53
  Dr. Jill Carnahan: Maybe before tpe?
• 18:54
  Dr. Jill Carnahan: Because TPE is this heroic, amazing thing that we have and I think it's going to become more common.
• 18:58
  Dr. Jill Carnahan: But before TPE, what is the basics 101 on that people should know?
• 19:04
  Dr. Nafysa Parpia: Yeah, I think that's such an important question because people are getting TPE all over the place now at various different clinics, but nobody is preparing them.
• 19:13
  Dr. Nafysa Parpia: Now, if you are a longevity patient and you're already in balance, you don't need as much preparation.
• 19:23
  Dr. Nafysa Parpia: Although I think that everybody has something brewing underneath these days because of combination of spike protein and multiple different toxins.
• 19:33
  Dr. Nafysa Parpia: So I think everybody needs some kind of support.
• 19:36
  Dr. Nafysa Parpia: The first thing I'm making sure is that my patients, our patients are having the cofactors they need for the detoxification process.
• 19:44
  Dr. Nafysa Parpia: So the minerals, amino acids, the vitamins, some supporting fat for them first before giving them any phospholipid therapies, before giving them any glutathione, before I'm trying to use any substances to pull toxins from outside of the cell, off the cell membrane supporting the body to be able to handle it when that load comes out.
• 20:11
  Dr. Nafysa Parpia: So amino acids, minerals, B vitamins to start.
• 20:15
  Dr. Nafysa Parpia: Sometimes we'll give them substances to get rid of the zonky cells, like spermidine, for example.
• 20:25
  Dr. Nafysa Parpia: I'm also making sure that they don't have any malabsorptive issues.
• 20:30
  Dr. Nafysa Parpia: That's a big deal.
• 20:31
  Dr. Nafysa Parpia: Just say we're doing a heroic treatment for detoxification cpe, or prior to that, using the phospholipid exchange therapies and glutathione.
• 20:44
  Dr. Nafysa Parpia: I want to make sure that they are, they're not constipated or they don't have diarrhea or they don't have leaky gut, because all three of those things going to just cause the toxic burden to recirculate into the system.
• 21:02
  Dr. Nafysa Parpia: Diarrhea, well, they might flush it out but their gut is so inflamed and toxins coming through it already inflamed that it's just gonna cause further leakage.
• 21:11
  Dr. Jill Carnahan: Right?
• 21:11
  Dr. Nafysa Parpia: Yeah.
• 21:12
  Dr. Nafysa Parpia: So I'm supporting their co factors dealing with senescence, dealing with the GI and of course I want the hormones balance.
• 21:24
  Dr. Nafysa Parpia: Now if someone comes in and they're hypothyroid, I do want to support their thyroid before I'm going to give them a lot of detoxification therapies.
• 21:35
  Dr. Nafysa Parpia: So those are the main things we're doing perfect.
• 21:38
  Dr. Eric Gordon: And I think the other, I think you didn't talk much about, you know, how you're using peptides, bioregulators, because in that first step, healing the gut.
• 21:49
  Dr. Eric Gordon: Because healing the gut is not easy.
• 21:52
  Dr. Eric Gordon: We can't always get it done.
• 21:55
  Dr. Eric Gordon: I think that's one of the important people to understand is that it's nice to have a stepwise process, but sometimes it's maybe a step here and a step there.
• 22:07
  Dr. Eric Gordon: It's not so linear because you have to dance with the individual that you're dealing with.
• 22:11
  Dr. Eric Gordon: Because we're all so different.
• 22:14
  Dr. Eric Gordon: Some people can tolerate dealing with an invasive bug early on and most other people have to do that later.
• 22:25
  Dr. Eric Gordon: Really need to support first.
• 22:27
  Dr. Eric Gordon: So I just, I don't want people to think that there's only one way to do this.
• 22:31
  Dr. Eric Gordon: It's just, it's that dance of understanding the person that you're dealing with and what their system can handle.
• 22:38
  Dr. Jill Carnahan: I would love for you to talk.
• 22:39
  Dr. Nafysa Parpia: About what happens when a person with Bartonella or any vector borne disease comes in and they want tp.
• 22:46
  Dr. Jill Carnahan: How do we prepare that person for it?
• 22:48
  Dr. Jill Carnahan: That's a great.
• 22:51
  Dr. Jill Carnahan: Yeah, I love that.
• 22:56
  Dr. Jill Carnahan: No, no, this is great because you're right, like the really complex.
• 22:59
  Dr. Jill Carnahan: What do we do?
• 23:00
  Dr. Jill Carnahan: Do we throw them into tb?
• 23:02
  Dr. Jill Carnahan: Before we do, I'm gonna, I'm bookmark that.
• 23:04
  Dr. Jill Carnahan: We're coming right back to that.
• 23:05
  Dr. Jill Carnahan: Let's get just a real brief.
• 23:06
  Dr. Eric Gordon: What is tb?
• 23:07
  Dr. Jill Carnahan: What is therapeutic plasma T exchange?
• 23:09
  Dr. Jill Carnahan: So that we all know what we're talking about and then we'll talk about.
• 23:11
  Dr. Jill Carnahan: I think that's a brilliant question.
• 23:15
  Dr. Eric Gordon: So therapeutic plasma exchange, lots of different names for it but basically it's just removing the plasma and basically removing the album and lots of antibodies that come out at the same time.
• 23:36
  Dr. Eric Gordon: It's a way of, to my mind it's giving the liver a little break.
• 23:43
  Dr. Eric Gordon: That's how I kind of think about it when people have a lot of autoimmunity it also is a way to give the immune system a break.
• 23:51
  Dr. Eric Gordon: When there is a lot of inflammation, it will give you a transient kind of a pause.
• 23:58
  Dr. Eric Gordon: And that can be, depending how often you do it and how many you do, it can be a few days to a few months.
• 24:05
  Dr. Eric Gordon: And it really depends on what it is you need.
• 24:09
  Dr. Eric Gordon: But essentially, hopefully, I'm sure, Jill, you've spoken about it, the process itself is unfortunately, a little.
• 24:17
  Dr. Eric Gordon: You need a large needle in both arms.
• 24:20
  Dr. Eric Gordon: But now that we have the flexible ones, it's really not too hard.
• 24:26
  Dr. Eric Gordon: It's very safe because your blood does not leave the system.
• 24:29
  Dr. Eric Gordon: It's a closed system.
• 24:31
  Dr. Eric Gordon: The blood goes out from one arm, goes through a centrifuge where the blood is separated by its density.
• 24:39
  Dr. Eric Gordon: And the red blood cell, all the cellular elements of red blood cells, the white blood cells, platelets, all go back in, and the plasma, the liquid, the other liquids of the body are removed.
• 24:55
  Dr. Eric Gordon: And it takes, you know, depend on the person, a few hours.
• 24:59
  Dr. Nafysa Parpia: We.
• 24:59
  Dr. Eric Gordon: We tend to run it slow.
• 25:00
  Dr. Eric Gordon: We usually everybody.
• 25:02
  Dr. Eric Gordon: We like to keep people at a slow rate.
• 25:04
  Dr. Eric Gordon: Some folks move it quick, but I think for sick people, slow is much better, especially if there's a mast cell activation, because the.
• 25:14
  Dr. Eric Gordon: The body is.
• 25:14
  Dr. Eric Gordon: The mast cells in your body are sensitive to everything, the whole system.
• 25:18
  Dr. Jill Carnahan: Yeah.
• 25:18
  Dr. Eric Gordon: When you get sick, they're like the barometers, right?
• 25:21
  Dr. Jill Carnahan: They're like.
• 25:23
  Dr. Eric Gordon: They're watching.
• 25:23
  Dr. Eric Gordon: They're watching.
• 25:24
  Dr. Eric Gordon: And when the blood flow is too quick, your body notices it, even though it's coming right back in.
• 25:31
  Dr. Eric Gordon: But it's a transient.
• 25:32
  Dr. Eric Gordon: It's only about 125, so it's that about like 4 ounces of blood that's out of your body at any one time.
• 25:39
  Dr. Eric Gordon: It's not a whole lot, but it's enough for sensitive people to notice.
• 25:43
  Dr. Eric Gordon: So we tend to go slow and.
• 25:48
  Dr. Eric Gordon: And we replace the albumin.
• 25:49
  Dr. Eric Gordon: And I think that's a really big deal because albumin is your body's.
• 25:55
  Dr. Eric Gordon: We always thought that medicine is what kept the fluid in the bloodstream.
• 26:00
  Dr. Eric Gordon: If you don't have enough particles in your blood, the blood leaks out.
• 26:03
  Dr. Eric Gordon: And albumin is the most particles you have in your bloodstream.
• 26:08
  Dr. Eric Gordon: That can really hold fluid in the bloodstream, but it also is your spine.
• 26:14
  Dr. Eric Gordon: It also gets into that, spaces between cells and picks up toxins.
• 26:21
  Dr. Jill Carnahan: It's a master, original binder, isn't it?
• 26:24
  Dr. Jill Carnahan: Albumin is the original binder, right?
• 26:27
  Dr. Eric Gordon: It is, it is.
• 26:28
  Dr. Eric Gordon: And the thing is, you recycle your own.
• 26:31
  Dr. Eric Gordon: About every three weeks, you recycle all your albumin.
• 26:34
  Dr. Eric Gordon: But if the liver is overwhelmed, it's not going to be able to really remove all those toxins.
• 26:42
  Dr. Eric Gordon: So the toxins just recycle.
• 26:45
  Dr. Eric Gordon: By removing all the albumin over 2, 3 hours and replacing it with fresh albumin, we give the whole system a chance to recalibrate and also for the liver to offload more toxic load.
• 26:59
  Dr. Eric Gordon: That's why in how often you should do tpe.
• 27:04
  Dr. Eric Gordon: Again, we're learning.
• 27:06
  Dr. Eric Gordon: I think one of the most important things people have to understand is that as Jill said In the beginning, TPE has been used in medicine since the 60s and a lot since the 80s.
• 27:16
  Dr. Eric Gordon: And by 1980 almost every major hospital had their own plasma creesis center.
• 27:22
  Dr. Eric Gordon: So we know a lot about it.
• 27:23
  Dr. Eric Gordon: But the idea of using it for anything but people who are basically close to dying or the other way plasma creases used is to harvest cells.
• 27:35
  Dr. Eric Gordon: If people need platelets or white blood cells, the machine can be set to remove them.
• 27:40
  Dr. Eric Gordon: But we're talking about giving you back all your blood cells.
• 27:44
  Dr. Eric Gordon: We're just taking anyway this has been used a long time, but using it for the kind of illnesses we're talking about now and using it for longevity, that's new.
• 27:59
  Dr. Eric Gordon: You know, Dr. Kiproff did work starting like writing about it probably 2010 or even before that they were trying it with dementias, but it's never.
• 28:11
  Dr. Eric Gordon: The development really has skyrocketed in the last three to five years.
• 28:15
  Dr. Eric Gordon: I always tell people when I got my machine, I was the first office that the person had ever trained anybody in and she came back like a year ago and she'd been in another office every week for the last six months.
• 28:28
  Dr. Eric Gordon: So things, yeah, it's exploding, but we're still learning.
• 28:33
  Dr. Eric Gordon: So I just want people to understand this, it's absolutely safe.
• 28:36
  Dr. Eric Gordon: But exactly how often to do it, who's going to benefit the most from it?
• 28:42
  Dr. Nafysa Parpia: That is still in the termination we're still researching.
• 28:47
  Dr. Jill Carnahan: Right.
• 28:47
  Dr. Jill Carnahan: But in that you're listening out there.
• 28:50
  Dr. Jill Carnahan: Yeah, but I do love that because we've had a ton of evidence.
• 28:54
  Dr. Jill Carnahan: Right.
• 28:54
  Dr. Jill Carnahan: Like the truth is there is really long term safety data when it's done well.
• 28:59
  Dr. Jill Carnahan: And now what we're doing is just a new indication that we're seeing this need as we have more plastics which have no real binder, we have more organophosphates, more mold and there's many toxins.
• 29:10
  Dr. Jill Carnahan: But the big ones, pfas, mold, organophosphates and plastics are getting harder to treat.
• 29:17
  Dr. Eric Gordon: Yeah, well, because they're getting so much more in our environment in Our bodies.
• 29:23
  Dr. Eric Gordon: You're not going to clean somebody's body in plastic with plasma paresis, but you're going to local load.
• 29:31
  Dr. Eric Gordon: You probably have to do about 60 of them to really clean the body.
• 29:34
  Dr. Eric Gordon: But the beauty of our system is that we just often need help.
• 29:38
  Dr. Eric Gordon: Because even though these are not natural to our environment, we created them, most of us are able to deal with them.
• 29:45
  Dr. Eric Gordon: So we just hope by lowering the load, we're going to help sicker people and help healthy people stay healthier longer.
• 29:54
  Dr. Eric Gordon: Because I've been in medicine long enough.
• 29:56
  Dr. Eric Gordon: I mean, 50 year olds, 50 years ago didn't feel that much worse than they did when they were 30.
• 30:04
  Dr. Eric Gordon: And now they're coming in and this whole thing of testosterone levels, I mean, dropping, whether it's from all the phthalates and other chemicals that we have in the body, I mean, who knows?
• 30:18
  Dr. Eric Gordon: But it's different.
• 30:20
  Dr. Eric Gordon: But it is.
• 30:20
  Dr. Eric Gordon: People are different.
• 30:21
  Dr. Jill Carnahan: People are.
• 30:23
  Dr. Jill Carnahan: Yeah.
• 30:24
  Dr. Nafysa Parpia: Even though.
• 30:24
  Dr. Eric Gordon: Even though.
• 30:25
  Dr. Eric Gordon: And these are the thing, that thing that amazes me about people today is that so many of the folks that I see are eating well.
• 30:34
  Dr. Eric Gordon: Okay.
• 30:35
  Dr. Eric Gordon: I don't get to see, I don't see the McDonald's folks often.
• 30:38
  Dr. Eric Gordon: These people are eating organic food, they're exercising, they're doing all the right things, but yet they're still in their 50s, feeling like their brain isn't working quite as well.
• 30:50
  Dr. Eric Gordon: They're more tired.
• 30:52
  Dr. Eric Gordon: And that's to me, not normal.
• 30:55
  Dr. Eric Gordon: When you go to indigenous places, people in their 70s are still functioning physically and mentally at pretty high levels.
• 31:03
  Dr. Eric Gordon: Not many places like that left.
• 31:05
  Dr. Jill Carnahan: Yeah, blue zones.
• 31:06
  Dr. Jill Carnahan: Right.
• 31:06
  Dr. Jill Carnahan: There's a few out there.
• 31:08
  Dr. Jill Carnahan: So let's switch to talking a little bit about.
• 31:11
  Dr. Jill Carnahan: Let's shift to talking a little bit about what you just mentioned before this, which was.
• 31:16
  Dr. Jill Carnahan: I want to know why it two parts here.
• 31:19
  Dr. Jill Carnahan: The one is the person with Lyme or Bartonella who.
• 31:23
  Dr. Jill Carnahan: Why would we maybe not throw them immediately into tpe and what would we do first?
• 31:28
  Dr. Jill Carnahan: But right along with that, why is there some people who do one TPE and they're like, I feel better already.
• 31:33
  Dr. Jill Carnahan: Whereas like my average patient who does TP in our clinic does maybe three and they start to feel better.
• 31:38
  Dr. Jill Carnahan: And some of them five or six and they start to feel better.
• 31:41
  Dr. Jill Carnahan: So let's first talk about why.
• 31:43
  Dr. Jill Carnahan: What's the difference in people feeling better?
• 31:46
  Dr. Jill Carnahan: And then if you have a complex patient with a very inflamed immune system, you alluded to this Nafisa, but how would you prep that patient for the complex issues?
• 31:56
  Dr. Nafysa Parpia: Yeah, so earlier when I talked about prepping that patient, I was talking about the different IV therapies I might use to bypass the gut so that now we can work at a cellular level.
• 32:08
  Dr. Nafysa Parpia: There's that.
• 32:09
  Dr. Nafysa Parpia: But I also want to modulate the immune system by speaking at the very beginning of this conversation about the downstream secondary illnesses that I want to calm down before I start to remove the early triggers, the triggers that came on in the patient.
• 32:30
  Dr. Nafysa Parpia: One of them is immune regulation, mcas.
• 32:35
  Dr. Nafysa Parpia: And so I use a lot of peptides and bioregulators to modulate the immune system.
• 32:41
  Dr. Nafysa Parpia: I always wanted to modulate the immune system first before detoxing, before killing persistent infections.
• 32:48
  Dr. Nafysa Parpia: And of course I tried with various herbs or supplements and patients who have MCAs.
• 32:57
  Dr. Nafysa Parpia: Talking about our patients, the ones who come to you, the ones who come to us, very often you give them herbs and they're going to have a mass activation syndrome response to those herbs because there are so many different components, chemical components, so to those herbs that is seen as a threat to their immune system.
• 33:19
  Dr. Nafysa Parpia: So as much as I want to give someone quercetin at first, for example, they often reject that.
• 33:27
  Dr. Nafysa Parpia: Now, peptides are, as you know, I'm listening to our listeners who are wondering.
• 33:35
  Dr. Nafysa Parpia: They are.
• 33:36
  Dr. Nafysa Parpia: They're so much more simple in their structure.
• 33:40
  Dr. Nafysa Parpia: Not simple in what they do, but simple in their structure.
• 33:42
  Dr. Nafysa Parpia: And because they're simple in their structure, my patients immune systems don't reject them very often.
• 33:50
  Dr. Nafysa Parpia: Rejected peptide, if it's given at the wrong time, like the right medication at.
• 33:54
  Dr. Jill Carnahan: The wrong time will be rejected.
• 33:56
  Dr. Nafysa Parpia: But if we're sticking with the peptides, the bioregulators that are working the system, these patients, their mast cell will respond very nicely to that will actually calm down.
• 34:10
  Dr. Nafysa Parpia: So I might use amloxinox.
• 34:14
  Dr. Nafysa Parpia: I'll use lorazatide often.
• 34:15
  Dr. Nafysa Parpia: I'll use lorazatide first for leaky gut because then we won't have antigens crossing through the gut barrier and entering into circulation, triggering mast cells systemically.
• 34:30
  Dr. Nafysa Parpia: I always wanted to heal burst and I found that using lorazotide is much more efficacious.
• 34:37
  Dr. Eric Gordon: It happens quicker.
• 34:39
  Dr. Nafysa Parpia: Yeah.
• 34:39
  Dr. Nafysa Parpia: If we could even reject, then I may come to amluxinox, which is a mass cell stabilizer.
• 34:48
  Dr. Nafysa Parpia: It helps with insulin resistance.
• 34:50
  Dr. Nafysa Parpia: A lot of these patients have met inflammation.
• 34:52
  Dr. Nafysa Parpia: So inflammation in every system, including the metabolic system.
• 34:56
  Dr. Jill Carnahan: Yeah.
• 34:56
  Dr. Nafysa Parpia: So the amluxinox will helpful that is that as well.
• 34:58
  Dr. Nafysa Parpia: And also with rhinosinusitis because they often have mold funguses, all kinds of microbes in their sinuses that don't belong there.
• 35:05
  Dr. Nafysa Parpia: So amaloxinox is an important one to bring in for many different reasons.
• 35:10
  Dr. Nafysa Parpia: I might bring in KPV next, but KPV has antimicrobial effects against staph, against Candida.
• 35:20
  Dr. Nafysa Parpia: So all these patients will flare if you bring them in kpv.
• 35:23
  Dr. Nafysa Parpia: There's whole conversation we could have about peptide.
• 35:25
  Dr. Nafysa Parpia: Today is not that day.
• 35:26
  Dr. Nafysa Parpia: But this is just a little sample of what I might do to begin modulating the immune system.
• 35:34
  Dr. Nafysa Parpia: So with peptides, with different bioregulators as they relate to the systems that need the most support.
• 35:42
  Dr. Nafysa Parpia: So for me, for my patients, starting this way, even before herbs is faster.
• 35:50
  Dr. Nafysa Parpia: Now, if somebody doesn't have extreme MCAs, you can give them all the herbs.
• 35:54
  Dr. Jill Carnahan: In the world, and they're going to.
• 35:56
  Dr. Nafysa Parpia: Do so well with that.
• 35:57
  Dr. Nafysa Parpia: Right.
• 35:58
  Dr. Nafysa Parpia: So one of the biggest things I do to prep them is to modulate the immune system first, especially mcas, because once we start to use tpe, they could have a mast cell response to that, which is why we go very slow.
• 36:11
  Dr. Nafysa Parpia: But also supporting that system as well.
• 36:16
  Dr. Jill Carnahan: Yeah, okay.
• 36:17
  Dr. Jill Carnahan: That makes a ton of sense.
• 36:18
  Dr. Jill Carnahan: And that's really the way that you're screening them makes a difference or even deciding timeline.
• 36:23
  Dr. Jill Carnahan: And that's also part of the experiential that both of you have, you know, decades of experience and kind of knowing not only just scientifically, but intuitively when that right time is for the patient.
• 36:34
  Dr. Jill Carnahan: Let's talk about just a little bit about.
• 36:36
  Dr. Jill Carnahan: Is there contraindications?
• 36:37
  Dr. Jill Carnahan: Who would you not give TPE to?
• 36:40
  Dr. Jill Carnahan: And is there any other things that patients should know about before they're seeking out someone who can provide tpe?
• 36:48
  Dr. Eric Gordon: Well, I think there's two main subgroups that I would be hesitant.
• 36:55
  Dr. Eric Gordon: One is not a reason not to do tp.
• 36:58
  Dr. Eric Gordon: That's folks with bartonella especially.
• 37:02
  Dr. Eric Gordon: That's probably one of the people we do most often, because pans and pandas is probably the strongest indication for tpe.
• 37:11
  Dr. Eric Gordon: It's actually one of the ones that you can get proved sometimes.
• 37:16
  Dr. Eric Gordon: And that's like that immune activation where you're making autoantibodies against proteins in the brain, antibodies in the brain, antigens in the brain.
• 37:29
  Dr. Eric Gordon: So those folks, and very often people talk about strep as being the trigger.
• 37:35
  Dr. Eric Gordon: But I think in the people who wind up in our clinic, the ones who've been sick for a few years with pans and pandas, Bartonella seems to be the bigger player.
• 37:46
  Dr. Eric Gordon: And the issue with Bartonella is that your antibodies are important to controlling it.
• 37:52
  Dr. Eric Gordon: And if you do one TPE, you'll be okay because you remove about only 50% of the total IgG in your body with one plasma paresis because you've got about 50% of it in your tissues.
• 38:05
  Dr. Eric Gordon: So it redistributes very quickly and it's in the tissues where everything needs to be to protect you.
• 38:12
  Dr. Eric Gordon: But if you do a series of them, by the time you get to 3tpe, you're down to about 12%.
• 38:18
  Dr. Eric Gordon: And if you have active bartonella, you can flare quite severely.
• 38:25
  Dr. Eric Gordon: So the choices with people with pans and pandas or even people with bartonella is can you treat, can you pre treat them?
• 38:33
  Dr. Eric Gordon: That's optimal if they can tolerate antibiotics and if you can't follow it with IVIG is critical.
• 38:42
  Dr. Eric Gordon: Okay.
• 38:43
  Dr. Eric Gordon: So I mean, depending on how sick they are and how severe the problem is, as little as maybe after the second one, 5 grams, but at least 10 by the third.
• 38:55
  Dr. Eric Gordon: And sometimes you need to even use, you know, full doses, 40 or 80 grams of albumin.
• 39:01
  Dr. Eric Gordon: Again, this depends on the patient and how severe they are, how sensitive and how sensitive they are.
• 39:07
  Dr. Eric Gordon: Because IVIG is not always the easiest thing tolerate, though I think they're doing better with the subcutaneous one these days.
• 39:15
  Dr. Eric Gordon: So that's for the bartonella.
• 39:17
  Dr. Eric Gordon: The only other big group, actually very tiny group that I've seen are people whose mitochondria are really not working at all.
• 39:28
  Dr. Eric Gordon: People who, you know, they're just totally depleted.
• 39:33
  Dr. Eric Gordon: And I think you can see that sometimes even as simple thing as an oat test, an organic acid test, when you can see that the mitochondria are really very dysregulated, they will not do well because it's a stress.
• 39:48
  Dr. Eric Gordon: I mean, it's not a major stress, but if you're functioning on your will alone and the system is really weak and the O test really tells us because unfortunately people self report of how badly they feel doesn't always correlate with how really depleted their system is.
• 40:10
  Dr. Eric Gordon: The people who I'm most concerned about are not the bed bound people.
• 40:14
  Dr. Eric Gordon: It's the people who are forcing themselves out of bed, the people who should be in bed, the ones who like push themselves and will exercise to the point of nausea because they have that they have.
• 40:28
  Dr. Eric Gordon: They're not me.
• 40:29
  Dr. Eric Gordon: I'm the kind of guy who goes, you know, like when's lunch?
• 40:32
  Dr. Eric Gordon: But the people who want to climb mountains are the people who get sick really badly because they will insist that they're fine.
• 40:40
  Dr. Eric Gordon: That's where it's really important to see what that energy supply is.
• 40:44
  Dr. Eric Gordon: Because if it's really depleted.
• 40:47
  Dr. Eric Gordon: Let's build you up for a little while.
• 40:49
  Dr. Nafysa Parpia: It doesn't take forever, two or three.
• 40:51
  Dr. Eric Gordon: Months and can get you to the place where the TP will really support you.
• 40:56
  Dr. Eric Gordon: Those are the two extremes I think are the people with Bartonella.
• 41:02
  Dr. Eric Gordon: We don't find as much of an issue with the viral people or even the Lyme people, but especially it's the bartonella ones that will really flare.
• 41:10
  Dr. Eric Gordon: But anybody with significant tick borne disease, if you can't pre treat, I think IVIG at least at some dose is indicated afterwards.
• 41:19
  Dr. Jill Carnahan: Love that you're talking about that because that's always been.
• 41:21
  Dr. Jill Carnahan: My question is patients with immune deficiency or immunocompromise or even underlying hypogammaglobulinemia, which means low IG level.
• 41:28
  Dr. Jill Carnahan: I'm like, okay, how would they.
• 41:29
  Dr. Jill Carnahan: And granted, just like you, I would say we need to absolutely be giving back that ivhen these really complex.
• 41:36
  Dr. Jill Carnahan: And as far as a standard for those with immune issues at all, that's what we do.
• 41:40
  Dr. Jill Carnahan: I'm sure you do the same.
• 41:41
  Dr. Jill Carnahan: Like that's kind of a standard.
• 41:44
  Dr. Jill Carnahan: This is so fun.
• 41:45
  Dr. Jill Carnahan: We're gonna have to do a part two because we're coming to a close shortly and I really want to.
• 41:50
  Dr. Jill Carnahan: This has been great though, great overview.
• 41:51
  Dr. Jill Carnahan: What I want to kind of end with is in the last 20 years or so that you've been practicing, what is the one thing that's made the biggest difference in the wellness and the healing of your patients?
• 42:03
  Dr. Jill Carnahan: Like obviously TB is this new incredible thing.
• 42:05
  Dr. Jill Carnahan: But you look back over all the years, can you think of.
• 42:08
  Dr. Jill Carnahan: And I'd love each of you to answer the one thing,.
• 42:17
  Dr. Nafysa Parpia: You know,.
• 42:20
  Dr. Eric Gordon: I.
• 42:20
  Dr. Nafysa Parpia: Want to say hope.
• 42:20
  Dr. Nafysa Parpia: But hope is not a new thing.
• 42:22
  Dr. Nafysa Parpia: That's an old ancient thing about the practices of all three of us.
• 42:26
  Dr. Nafysa Parpia: So what is the one new thing?
• 42:29
  Dr. Nafysa Parpia: You know, for me it is peptides and bioregulators.
• 42:34
  Dr. Nafysa Parpia: And bioregulators are a class of small.
• 42:36
  Dr. Eric Gordon: Peptides, food for those who don't know.
• 42:38
  Dr. Nafysa Parpia: So I would say the whole crunching overview of the biggest thing that's been the impact, the physical impact is those, the peptides and bioregulators because they're so like I was saying, there's such small molecules that can actually make a difference.
• 42:57
  Dr. Nafysa Parpia: There's a lot of naysayers out there.
• 42:59
  Dr. Nafysa Parpia: I've been working with these small molecules for 10 years and so I see the impact they can have on my patients.
• 43:08
  Dr. Jill Carnahan: So I couldn't agree more.
• 43:11
  Dr. Jill Carnahan: So powerful.
• 43:12
  Dr. Jill Carnahan: It's so fun to have these new tools.
• 43:13
  Dr. Jill Carnahan: Dr. Gordon, what's your thinking?
• 43:16
  Dr. Eric Gordon: Oh, God.
• 43:20
  Dr. Eric Gordon: I think it's just learning that there isn't.
• 43:31
  Dr. Jill Carnahan: That there isn't one thing.
• 43:35
  Dr. Eric Gordon: No, seriously.
• 43:36
  Dr. Eric Gordon: Because I think that what I've watched is I started off doing this type of medicine in 92, you know, after.
• 43:44
  Dr. Eric Gordon: So I've been doing this for almost 45 years, 46 years.
• 43:47
  Dr. Eric Gordon: So.
• 43:48
  Dr. Eric Gordon: And what I have seen is just how our knowledge grows.
• 43:52
  Dr. Eric Gordon: Okay.
• 43:53
  Dr. Eric Gordon: And it just understood.
• 43:55
  Dr. Eric Gordon: That's what's been amazing.
• 43:57
  Dr. Eric Gordon: Okay.
• 43:57
  Dr. Eric Gordon: Is because.
• 43:59
  Dr. Eric Gordon: And it's a circle.
• 44:00
  Dr. Eric Gordon: And really what it comes back to, it's just.
• 44:03
  Dr. Eric Gordon: Yeah.
• 44:04
  Dr. Eric Gordon: We just have to know that.
• 44:09
  Dr. Nafysa Parpia: Yeah.
• 44:10
  Dr. Eric Gordon: I think chronic inflammation is what I would come down to.
• 44:12
  Dr. Eric Gordon: The one thing is just learning how important that the body's own defense system is what's keeping us ill.
• 44:20
  Dr. Eric Gordon: It's that simple.
• 44:20
  Dr. Eric Gordon: Okay.
• 44:21
  Dr. Eric Gordon: Is that your body system is the problem.
• 44:24
  Dr. Eric Gordon: And it's not that it's bad, it's just.
• 44:27
  Dr. Eric Gordon: It's lost its balance and that's what keeps people ill, you know, and it's.
• 44:35
  Dr. Eric Gordon: I think it's that complex because the problem is that we don't understand the immune system.
• 44:43
  Dr. Jill Carnahan: If I summarize.
• 44:44
  Dr. Jill Carnahan: And again, this has been so powerful because tpe, I do think, is a future modality.
• 44:49
  Dr. Jill Carnahan: I love the idea of peptides.
• 44:50
  Dr. Jill Carnahan: And these days, I couldn't agree more.
• 44:52
  Dr. Jill Carnahan: Finding them to be so powerful.
• 44:53
  Dr. Jill Carnahan: And we're just going to continue learning more.
• 44:56
  Dr. Jill Carnahan: I do believe, under the doctor's supervision, in the right way.
• 44:59
  Dr. Jill Carnahan: They're so powerful, so safe, and so effective.
• 45:02
  Dr. Jill Carnahan: I don't want to gloss over something you said, Nafisa, you said, oh, wisdom, but hope.
• 45:06
  Dr. Jill Carnahan: I think all of us agree.
• 45:08
  Dr. Jill Carnahan: This kind of being with a patient, giving them this place where they have hope.
• 45:11
  Dr. Jill Carnahan: And even why I do the podcast here, is bringing brilliant people like you to give our audience hope that maybe they thought they wouldn't have, or maybe they thought they were out of answers.
• 45:21
  Dr. Jill Carnahan: And so I kind of love ending there because I know we all agree on this spiritual, emotional level, holding that patient in a safe container, giving them hope, really being curious, which is what you alluded to, Dr. Gordon, in our whole decades of experience, is always remaining curious and learning more and realizing that how humbling it is because we only have scratched the surface.
• 45:42
  Dr. Jill Carnahan: Right?
• 45:43
  Dr. Jill Carnahan: And I know we all share that.
• 45:44
  Dr. Jill Carnahan: So most of all, I just thank you both for being your brilliant selves and bringing this knowledge to the world.
• 45:49
  Dr. Jill Carnahan: If people want to know more about your clinic, where can they find you?
• 45:54
  Dr. Eric Gordon: Medical dot com.
• 45:56
  Dr. Eric Gordon: That's the simple place and everything for other places, but that's it.
• 45:59
  Dr. Eric Gordon: That's the simple place.
• 46:00
  Dr. Jill Carnahan: Awesome.
• 46:01
  Dr. Jill Carnahan: And you guys do all kinds of education.
• 46:02
  Dr. Nafysa Parpia: Thank you so much for tapping in.
• 46:03
  Dr. Jill Carnahan: Well, you're so welcome.
• 46:04
  Dr. Jill Carnahan: It's always fun and such a pleasure.
• 46:08
  Dr. Eric Gordon: And I guess I want to mention is that we have Gordon Medical Forum is where we interview people like yourself.
• 46:16
  Dr. Eric Gordon: You've been with us and, you know, and it's a place that we keep learning.
• 46:19
  Dr. Eric Gordon: I mean, that's the whole reason that all of us are doing this, because we want to get the hope out to people.
• 46:24
  Dr. Eric Gordon: And it's an opportunity to really talk to smart doctors and smart thinkers and figure out what we're missing and what's the next possibility because we all, you know, people are ill for so many different reasons.
• 46:39
  Dr. Jill Carnahan: And I have, like I said in the beginning, I mean this from my heart.
• 46:42
  Dr. Jill Carnahan: I have deepest respect for both of you because you're putting out incredible information in the world.
• 46:46
  Dr. Jill Carnahan: So, guys, if you are walking, driving somewhere, you can't write this down.
• 46:50
  Dr. Jill Carnahan: It's in the show notes.
• 46:51
  Dr. Jill Carnahan: We're going to link to Gordon Medical Forum and your medical clinic.
• 46:54
  Dr. Jill Carnahan: It'll be in the notes.
• 46:56
  Dr. Jill Carnahan: And thank you again both for coming on the show.
• 46:59
  Dr. Nafysa Parpia: Thank you so much.
• 47:00
  Dr. Eric Gordon: It's a pleasure, Jill.
• 47:01
  Dr. Eric Gordon: Always fun to talk to you.
• 47:02
  Dr. Nafysa Parpia: The respect is mutual.
• 47:03
  Dr. Nafysa Parpia: The respect and the love is mutual.
• 47:05
  Dr. Jill Carnahan: Thank you.
• 47:09
  Dr. Jill Carnahan: Guys.
• 47:09
  Dr. Jill Carnahan: Hope you enjoyed that great episode with Dr. Parpia and Dr. Gordon.
• 47:13
  Dr. Jill Carnahan: Gordon from the Gordon Medical Clinic.
• 47:15
  Dr. Jill Carnahan: You can find all their information with the links below.
• 47:18
  Dr. Jill Carnahan: They are some of my favorite people to talk to.
• 47:20
  Dr. Jill Carnahan: Just always on the cutting edge of complex chronic illness.
• 47:23
  Dr. Jill Carnahan: And no surprise, they are well versed in using TPE like I am in my clinic.
• 47:28
  Dr. Jill Carnahan: We all found it to be incredibly helpful.
• 47:30
  Dr. Jill Carnahan: And the backstory on this episode is were at a conference recently at A4M in Las Vegas and ran into them, gave them big hugs and how are you doings?
• 47:38
  Dr. Jill Carnahan: And then we're both talking about the future of medicine, Peptides and tpe.
• 47:43
  Dr. Jill Carnahan: And I said, hey guys, let's do an episode on that on my show.
• 47:47
  Dr. Jill Carnahan: And here we are recording in the middle of summer.
• 47:50
  Dr. Jill Carnahan: This episode will be released in September.
• 47:52
  Dr. Jill Carnahan: And we talked about this, I don't know, nine months ago.
• 47:55
  Dr. Jill Carnahan: So here we are.
• 47:56
  Dr. Jill Carnahan: Hopefully you enjoyed that episode.
• 47:57
  Dr. Jill Carnahan: Please do like and subscribe.
• 47:59
  Dr. Jill Carnahan: Hit that bell to be notified of future episodes.
• 48:02
  Dr. Jill Carnahan: We are over 1 million subscribers.
• 48:04
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• 48:10
  Dr. Jill Carnahan: We're grateful for every single listener and for every review.
• 48:14
  Dr. Jill Carnahan: So I will see you again next week for another episode of Resiliency Radio, right here on the Dr. Jill YouTube channel.