Podcast: Demystifying Mast Cell Activation Syndrome

Demystifying Mast Cell Activation Syndrome with Nathalie Niddam

Could you imagine a condition that affects virtually every organ, eludes the standard diagnostic criteria, and causes multi-system inflammation? Meet the perplexing world of mast cell activation syndrome (MCAS). MCAS is an elusive condition that affects many, yet remains largely misunderstood. MCAS is a syndrome that triggers multi-system inflammation, and due to its diverse range of symptoms, it often eludes typical diagnostic processes. It has a profound impact on both the body and mind. Mast cells are integral to our innate immune system, playing a crucial role in safeguarding us against foreign invaders, allergens, and environmental toxins. However, potential triggers of mast cell hyperactivity can range from environmental toxins to mold.

Today I’m with Dr. Bruce Hoffman and we dissect this complex condition and delve into the critical role of mast cells in our immune system. Learn how mast cells, our body’s fierce protectors against toxins, might turn hyperactive due to triggers like environmental toxins, heavy metals, or mold, launching a cell danger response that could send your body into a protective shutdown. The conversation takes a deeper turn as we explore the intersection of physical and mental health. Focusing on those battling MCAS and early developmental trauma, Dr. Hoffman shares invaluable self-regulation strategies and lends insight into the significance of neurofeedback and building a window of tolerance.

Dr. Hoffman is board-certified and has a fellowship in anti-aging medicine as well as a Master’s degree in clinical nutrition. He is also a certified functional medicine practitioner. In addition to his clinical training, Dr. Hoffman has studied with many of the leading mind-body and spiritual healers of our times, including Deepak Chopra, Paul Lowe, Osho, Ramesh Balsekar, and Jon Kabat-Zinn. He has shared the stage with Dr. Deepak Chopra, Dr. John F. Demartini, and he continues to spread his inspiring vision of healing and wellness with audiences and patients around the world.

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Find more from Dr. Bruce Hoffman:

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What we discuss:

(0:03:00) – Understanding Mast Cell Activation Syndrome

(0:15:27) – Treating Physical and Mental Health Impacts

(0:23:09) – Understanding and Healing Unconscious Dynamics

(0:38:05) – Treatment and Management of Histamine Intolerance

(0:45:12) – Building Resilience and Shifting Healthcare Paradigms

(0:57:19) – New Health Curriculum for Transformation

Key takeaways:

Mast Cell Activation Syndrome (MCAS) is a condition where mast cells, a component of our immune system, become hyperactive and trigger inflammation across multiple systems in the body. This can result in a wide range of symptoms and can be difficult to diagnose. Potential triggers of this hyperactivity can include environmental toxins, mold, and certain foods.

Physical and mental health are interconnected when it comes to MCAS. Individuals with this syndrome may have early developmental trauma which can exacerbate symptoms. Learning self-regulation techniques, such as neurofeedback, can be beneficial for managing stress and promoting balance in

Full Transcript

This transcript was automatically generated, please excuse any errors.


Welcome to the biohacking superhuman performance podcast. My name is Natalie Niddam. I’m a nutritionist and human potential and epigenetic coach. And I created this podcast to bring you the latest ways to take control of your health and longevity. We cover it all, from new technology to ancestral health practices, personalized interventions, and a very special interest of mine: peptides. Enjoy the show.


Hey, folks, welcome back to the show. Today’s episode is going to be amazing. It’s a topic I’ve been wanting to explore forever, and a doctor I’ve wanted to have on the show for even longer. His name is Dr. Bruce Hoffman. And we’re going to talk about mast cell activation syndrome, cellular membrane stability and everything associated with it. But before we do that, I do want to thank one of our sponsors, who is Mito pure from timeline nutrition, so metal pure. If you haven’t been listening to this podcast for too long, you might not know is the first product to offer a precise dose of your lithium a that supports my toppity and increases cellular energy. So why is this important? Well, mitochondria become damaged and dysfunctional over time, which leads to the production of harmful byproducts and the disruption of normal cellular function. This is a huge issue. My toffee G ultimately helps in maintaining healthy mitochondria by eliminating these damaged ones, which allows for the proper functioning of cells and overall cellular health. It also encourages the body to make new mitochondria. So optimizing your cellular health is crucial for maintaining healthy tissues, organs and systems in your body. So not just it might appear has been shown clinically to improve performance in muscle. But it’s also been shown to improve immune function, brain function, heart function, it is amazing. Well, I mean, frankly, mitochondria are critical to every single system. So might appear from timeline nutrition gives you three ways to get your daily dose of 500 milligrams of your lithium a, there’s a delicious vanilla protein powder that combines muscle building protein with the cellular energy of myopia. There’s also a berry or a ginger powder that easily mixes into smoothies or just about any drink. I love it in my yogurt in the morning, sometimes if I have yogurt, and for my as part of my breakfast. And finally they have these amazing soft gels that you can use for travel, I would recommend that you consider the starter pack because that lets you try all three forms of myopia so you can figure out which one is your favorite. So timelines offering 10% off your first order of myopia, all you have to do is go to timeline nutrition.com, forward slash net 10 and use code net 10 to get 10% off your order. All right, now let’s talk a little bit more about the episode. So imagine a condition that affects virtually every organ eludes the standard diagnostic criteria. And this is where people get gaslit all the time, and causes multi system inflammation. Meet the perplexing world of mast cell activation syndrome, otherwise known as M. Cass. Today I’m joined by Dr. Bruce Hoffman to discuss this complex condition and explore the critical role of mast cells in our immune system. Mast cells are a body’s first line of defense against foreign invaders, allergen and environmental toxins. However, they can become hyperactive in response to triggers like environmental toxins, heavy metals, mold, and even early developmental trauma. And we talked about that in the episode. This can ultimately lead to a cell danger response, which essentially sends the body into protective shutdown. And if this is you, you might be that person that seems to react everything. Dr. Hoffman is amazing. He’s just the kindest, most knowledgeable, unbelievable guy. He’s board certified has a fellowship in anti aging medicine, as well as a master’s degree in clinical nutrition is also a certified Functional Medicine Practitioner. In addition to his clinical training, Dr. Hoffman has studied with many of the leading mind body and spiritual healers of our times including people like Deepak Chopra, Paulo, our show, Ramesh balsa car, and Jon Kabat Zinn, who wrote the book, Why zebras don’t get ulcers. Rate, great book that highly recommend you read that Dr. Hoffman specializes in complex medical conditions. And he is the medical director of the Hoffman center of integrative medicine in Alberta, in Canada in Calgary and Alberta and Canada. And so to learn more about Dr. Hoffman or to reach out to him if you think that you might want to talk to him about something that’s going on in your world, you just need to go to the Hoffman Hoffman center.com. We’ll put that in the show notes. And that’s H O F F ma N center C E N T R e.com.


harm. And that’s the website and you can find out about all the amazing things that they do there. Okay, before we jump into the episode, I have one more sponsor I need we need to thank and then we’re going to rock on. So one shot you about element and an electrolyte drink that I am obsessed with.


I dump a single packet into my one and a half liter water bottle. Now this is important because if you put it in too little water, it’s gonna be too concentrated so one and a half liter bottle, and I sip on it throughout the day. And not only does it help me drink more water because it tastes amazing, but it also ensures that my electrolyte levels are always balanced. And these this balance ensures that you regulate fluid balance and helps with digestion circulation temperature regulation helps to maintain the body’s pH balance, which is ultimately vital for enzyme activity and biochemical reactions, as well as optimizing nerve and muscle function element contains a science backed electrolyte ratio with 1000 milligrams of sodium, 200 milligrams of potassium, and 60 milligrams of magnesium with no junk, no sugar, no coloring, no artificial ingredients. No gluten, no fillers. Bottom line, no BS. So right now element is offering my listeners a free sample pack with any purchase. That’s eight single serving packets free with any element order. And this is an amazing way to try all eight flavors or share element with a salty friend like I just did last night. So get yours at drink element.com forward slash net. Now element has no E’s in it. So drink lm n t.com forward slash net. And this deal is only available through my links. So you’ve got to go there. Now one last thing I will say about these guys is they offer a no questions asked refund policy, you get to try it totally risk free. If you don’t like it, just share what’s left with a salty friend, and they will give you your money back with no questions asked, you literally have nothing to lose. So thank you. Thank you. Thank you. Thank you guys for being here. Thank you for listening to the podcast, please make sure that you share it with your friends in your network if you get value from it. And of course, if you’re feeling inspired, leave us a review. And that’s it. Let’s get in. Let’s get into it with Dr. Bruce Hoffman. Hey, folks, just a quick reminder that all of the information presented in this podcast is for informational purposes only. No medical advice, no diagnosing no treatments suggested here. Before you try anything that you hear about or learn about here. Make sure that you check with your medical provider. Dr. Bruce Hoffman, welcome to the show. It’s a pleasure to have you here today. Thank you very much. Yeah, so we are gathered here today we’re going to, we’re going to explore let’s say the universe or the world of M casts, I mean, there’s many other things I know you could talk to speak to, but m Cass being mast cell activation syndrome, which is, you know, in good company with one of the most vexing kind of health issues that people deal with. And I think in part because it’s not well understood, it’s very disruptive to people who suffer with it. And it’s tough to get a diagnosis. And even if you get a diagnosis, it’s really hard to figure out how to stabilize those little mast cells. So I thought maybe we could start with explaining to people what the heck a mast cell is and why we even need them because, you know, that’s just get rid of the buggers if they’re overactive.


A huge mistake, but you know, yeah, we just die a lot quicker. Exactly. You wouldn’t suffer but maybe one but okay, well, let’s talk about mast cells and what they do. Sure, so you know what, my cells are part of the innate immune system, and they provide protection against invading toxins. So they send out their bad white 1% of your white cells. So they’re not a huge component, but they are all the surfaces of your tissue, they in your eyes, your skin, your GI tract, your lungs, and they they send out up to 1000 mediators of inflammatory substances in order to protect you from further toxic load. That In so doing, they create a huge sort of multi symptom multi system array of symptomatology, and in every single organ system of the body. If you look at Dr. Efrain is one of the pioneers in this work. If you look at his sort of, there’s a chapter he hasn’t one of his books, he lists all the organs and all the symptoms as every single symptom in the book really, in every single organ can be potentially a mast cell activation issue. Wow patients you present with mast cell activation. You know, they go from pillar to post from specialist to specialist trying to find out why they don’t feel well with waxing and waning symptoms over a lifetime usually, and they never get diagnosed. They never get appropriately diagnosed. Because it’s not just allergy it’s inflammation with or without allergy.


So you can have inflammation and not be have the IGE allergy typical symptomatology, like rhinitis, or asthma or urticaria, or any of the IGE to allergy types and things that you can be massively inflamed from muscle activation, and have various symptoms that just evade normal diagnostic criteria. Right? Yeah. So someone tell if they have inflammation, just inflammation, or if their inflammation is linked back to their mast cells.


Suspicion really, you know, you’re just people who present with my cell activations, and they’ve been, you know, I’ve been sick for as long as I can remember, I had allergies as a child, I’ve been intolerant. I’ve got an unexplained anxiety and insomnia, that one go away. And they just have got exam or skin rashes that won’t respond. I got poor wound healing abilities, I got cross and nodules on my skin that seemed to grow cherry angiomas that seem to come and go, because my cells release growth factors that create little skin growths and skin tags and angiomas. So this is multitude are present multitude


ways of presenting, and if you don’t really have a high index of suspicion, you can often miss the diagnosis. Wow, okay, what’s the react to all the supplements? They react to all the foods?


This? I mean, I’ve spoken to people who can’t take a supplement like they can we get them in our group, you know, like they, they’re like, I can’t take any supplements. I’m down to four foods. I don’t know what to do anymore. So a patient today for foods can’t take anything. Like, what is that? That’s insane.


It’s insane. So what do we think? Is there any theory about what causes these mast cells to go haywire? Like? I mean, this is clearly not, you know, this is clearly not normal. This is not the way that they’re intended to work. Like, it’s almost like an autoimmune thing, right? It’s an immune system gone into overdrive. So what might drive what do we think might be driving myself into the state of hyper vigilance or hyperactivity? Well, we live in a world that is somewhat


overwhelming in terms of its capacity to


invade our defenses, we really have no idea how


vulnerable we are to food, mental, environmental, toxins, and how our body is just struggling to survive and keep abreast of this incoming wave of toxicity. And it’s really overwhelming. And it’s not hyperbole. It’s not conspiracy theory. It’s real. Ya know, we just wanted just at this moment in our evolution to put up with all the microplastics and heavy metals and insecticides and pesticides, and EMFs and mental stresses and buses that demand things of us. And, you know, it’s endless, the toxic load, and my cells are trying to keep up. And they trying to just protect you from going into this inflammatory response that that then shuts down your body in the so called Cell danger response.


Well, if you look at the Porges, autonomic polyvagal theory, that dorsal vagal response, where you shut yourself down to withdraw you from life, so you don’t keep exposing yourself to the things that are incoming.


Yeah, it’s like the first infantry men in the on the battleground trying to say, hey, you know, I’m going to protect you, and make sure you don’t die. But in the meantime, we can wreak havoc with your organ system shutting it down.


Out of life, stop doing it. Yeah.


Question by the Kandra. We’re going to produce a fatigue state so you can’t get up and keep doing what you’ve been doing.


That’s how it works. And then Robert Navarro cell danger response is absolutely clinically relevant. If all those people are watching, listening, if they don’t aren’t familiar with Robert Nivas theory of the cell danger response, I would highly recommend they get up to speed immediately on, on his work, which has been going on for 10 years now. Which he has carefully put together through multiple research papers, saying that you know, in the mitochondria, the first the canaries in the coal mine, you got these cells, you got 70 trillion cells. Inside each cell. We’ve got, you know, 100 to 2000 mitochondria, mitochondria,


drive the ATP


We produce like 70 kilograms of ATP a day is like ATP is is it?


Is it and mitochondria, they the most sensitive to this whole incoming onslaught. And as soon as they detect an overload of stresses, they change the outer membrane, they change their phospholipid structure, they change the voltage, and they literally undergo autophagy and die. And they take with them.


And my cell activation is one of the ways in which mitochondria get destroyed micelle, the mediators of inflammation


and they get all the factors, you know, the chemicals, the metals and the mold. Okay, so let’s so so let’s talk about those all of those triggers, right. So I mean, you’ve named now you know, so there’s, there’s the environmental toxins. So there’s the mold, there’s the heavy metals, there’s the pollutants in the air, there’s non native EMFs that you mentioned, as well, which some people seem to be more sensitive to than others, but anybody who thinks they’re not being affected by them, I used to be one of those people. I used to be like, Ah, I’m immune to EMFs until I was presenting at an event that happened to be in the middle of a field in Kentucky, where you couldn’t so much get a cell phone respond like a cell phone signal in this place. And my aura ring kept working because I, you know, I just wore it, but it was, The nights were so cold, and it was rainy and uncomfortable. And my HRV scores were off the charts. Yeah. And I was like, and it was it was the first time I probably the first time I’d been away from from the soup that we live in. And I was just like, wow, that’s nuts. Like you don’t know that you’re, you don’t know your body’s responding something to something because sometimes because it’s become your new normal like this is just how you are. Yeah, interestingly, my cell activation works EMFs trigger my cells to create these inflammatory mediators, which open up the ionic receptors in the cell membrane, which increase intracellular calcium, which increases intracellular glutamate, which is neuro excitatory Neuro Stimulator. So my cell EMF stimulate my cell activation. That’s how they work. Wow. That’s how they wreak havoc. Interestingly, just on that point, I recently went to South Africa, where they have load shedding. They have what? Load Shedding every hours, they shut off electricity to certain parts of the country. Oh,


yeah. So in Cape Town, and every two or three hours, electricity goes up dead.


And interestingly, the people around me with EMF sensitivity were having the time of their life, they felt so relaxed. So the whole country is in crisis, because you can’t get electricity. But the people with EMF will say, this is heaven. I want to move here. Thank God, that’s hilarious. It’s crazy and hilarious. Okay, so what do we do? So what do we do? So I mean, look, EMFs is the big knock, right? Because you cannot remove yourself from EMF. And so is it possible and I’m sorry, I’m just literally asking you this. We’ve we’ve mentioned all these different toxins? Is it possible that by reducing other toxins in the body by reducing that overall toxin load, we can help to rebuild some resilience so that the EMFs aren’t as dramatic?


Yes and no. So people who are electromagnetic hypersensitive will always tend to be you know, electromagnetic sensitive, but you can definitely lower the threshold. So, I mean, if I look at the major stressors for my cell activation, number one that trumps it, early developmental trauma, interesting. Yeah. Trump’s at 100% of the time, due to the dysregulated HPA axis, the hypothalamic pituitary adrenal cortisol, adrenaline, noradrenaline axis, those individuals are very susceptible to mast cell activation. And that pathway has been well worked out by high cortisol, adrenaline triggers Maesa release. So early developmental trauma with ongoing stresses, mental stresses, number two would be mold. Mold is a massive trigger of muscle activation.


And then number three is food. I histaminergic, high inflammatory foods. Those are the top three in my well, then we go look for all the rest of metals, the chemicals, the infections and everything else.


BIOSIS the microbiome triggers? Yeah, yeah, it always comes down to those same things. Okay. So it you know, it is crazy, right? It’s, it’s, we’re, as I interviewed different people, we’re talking about different issues. So often it just comes right back to all these things and the, the early developmental those aces as people call it aces


that early developmental trauma is so again, it’s under reported, it’s even under acknowledged, I think by individuals themselves, right? It’s, it’s gaining momentum. I mean, I don’t think you can take a good medical history without doing an a score. Even though the a score, isn’t it, there’s much more to it. The thing that we look for mostly is interrupted bonds with a mother. Interesting. When there’s interrupted bonds with the mother, the HPA axis is usually quite dysregulated. And that systems in trouble. And you know, and it’s all unconscious dynamics, if you don’t do a Family Constellation, where you look into the unconscious dynamics, and entanglements of family systems, you won’t know that it’s that potent of an issue, then you look at heart rate variability and see if they tweaked in the sympathetic dominance. And then you look at q e g, is looking at brainwaves to see if they have dysregulation between the different delta theta, alpha and beta brainwaves. And you can tell this, these systems that are so dysregulated, and we do stress assessments looking for


physical stress based on mental triggers. And the first thing I do with every muscle activation patient is look at these parameters. And suggest and insist that they learn self regulation as a primary strategy before they even address the rest of it. If these individuals aren’t self regulating, and having the capacity to move between sympathetic and parasympathetic as you heal in that coherent zone between the two, they permanently in fight flight or collapse. Don’t even begin your work with the rest of it. It gets them to self regulate. Yeah, over and over and over every day, like working your biceps, morning, night, every hour. It takes nine months to a year to shift the neuroplasticity modules in the brain and to shift the default mode network that creates your sense of self is lot of work. Nobody wants to do it. Yeah.


No, no, everybody wants what Wait, wait, surely there’s a drug or a supplement I could take that would be so much easier than breathing, or this coherent business. So what are the two? You’re laughing? I know, I know, I know, listen, we all want the easy answer. And and sometimes humans, it’s actually is an easy answer. It just takes time and work and an application. So what have you found to be the best tools? And I’m sure it varies from person to person. Because I mean, I even find, you know, you’re, we’re all in a world where we’re in a sympathetic state. So even without M casts we’re trying to teach we’re trying to help people to figure out how they’re going to get themselves out of this constantly activated state. And I’ve found that what works for one doesn’t resonate for the other very, very individualized. Yeah, yes. So how we start with this is we start with even good ol Heart Math and wave training, love heart match, we use that we use that. Then we use neuro biofeedback we use neurofeedback, we use that five different six different strategies of Neurofeedback mind left brain tap all sorts of things. Yeah, then we do vagal tone strengthening with Razia Max and other devices. And if that’s not helpful, we then refer to as E practitioners to do somatic work to assist people in building a window of tolerance, whereby they can stay somewhat stabilized in the world of, you know, incoming stresses and they don’t just integrate and D granulate. Much. It’s the first sign of something that they can’t handle, you know, that is the core of treating myself in my world, in the world I work with, if that isn’t enough, and usually it is enough to begin the process of then building back up. But that’s where we begin is self regulation, neuro biofeedback. Building a window of tolerance, building self regulation, coherence so that they’re not so disintegrate, they don’t just, they don’t


fall apart as easily. It can be a lot of work, you know, it can be a lot of work. Well, I mean, in the case, I mean, when you’re talking about early developmental trauma, you’re talking about broken bond disrupted bonds with mom when they were babies, like we’re talking about deep deep work here like are this isn’t just, you know, I’m gonna I’m gonna learn how to do a box breath and everything’s gonna be great. I mean, box breath might be helpful, but this is I mean, this is this is so interesting, right? Because it takes a physiological condition into the realm of, of mental health. It’s interesting thing, Natalie is that you know, we have this Cartesian body


Mighty body mind split, which we know is not true. But the body mind is one thing, there is no separation, there’s not there isn’t a body and a mind is, is one phenomena. And those two are equal. Yeah. So whatever your internal dialogue is, from your early development for all inherited family trauma, you can act out your


inherited trauma, early developmental trauma, if you don’t try and create some conscious insight into what actually happened, and what you’ve inherited, and what’s not yours to act out, you can’t begin the process of downregulation because I work in these layers and levels of healing from you know, the so called self was or soul down to mind and ego down to emotion down to brain and energetics down to biology and structure down to toxicology and the external environment. If you don’t heal at the higher levels, which trickled down to biology, you can’t go at biology now because all of this is impeding the you know, it’s impeding the flow of electrons


on right, like they’re, the body’s hanging on to stuff and it won’t let go. Unconscious dynamics of entanglement can ruin your life. And you won’t even know it because it’s before memory was developed at the age of three or four. Yeah, but you need somebody who’s skilled in how to interpret family systems inherited trauma and early developmental trauma and apply it to physiology and practice. It’s just it’s it needs you need to somebody a very well trained in that who can really lead you through that and put you into a practical approach how to manage it. Yeah. So But now everybody that that’s that present with them cast doesn’t necessarily have that early childhood trauma. And yeah, but But you but you’re going in position is most if not all, people still have some degree of of self regulation issue in the parasympathetic nervous system. Almost always Yeah. which then translates into the gut through the vagus nerve of course, so they get cut this motility and all sorts of dysautonomia is of the vagal tone. Then they get you know, you have these pent these triads and Pentair symptoms go together. We’ve got the muscle activation pots, hypermobility people,




There’s a triad, you see them a lot together. Then you get the Pentel where you get this autonomia and you get autoimmune disease. That’s the pintech. So that adds on to the first three. Yeah, they’re all they will go around like a you know, like a water in a sort of drain, they swirl around each other, and the one precedes the other, then they just sort of feed of each other. And the phenotype that presents often females aged 15 to 45 is a very common phenotype of people presenting in that way. But we’ll have a mobile much more my so much more artsy. Not a Potts, a lot of disorder. Yeah. So but with EDS, it’s which is Ehlers Danlos Syndrome, for those of you listening who don’t know what EDS is, that’s a genetic condition, is it not?


There’s different subcategories of Ehlers Danlos, peros danlos, sort of hyper mobile type three, there’s no genetics, particular genetics that drive it. There’s just a predisposition to it. But there are genetic, Ehlers Danlos conditions of course, yeah. Well, these people who just don’t make collagen, or they don’t make it efficiently, or they don’t make enough or they don’t make a certain type. I mean, I have, I have a friend. You know, I didn’t know anything about EDS. And I mean, this is a woman who literally had to have all of the teeth pulled out of her mouth because they were just breaking like she, you know, her body wasn’t forming the connective tissue


to hang on to them. Like it’s, it’s pretty intense, at its most extreme, is just, you know, people draw you dizzy when you stand up. That’s my patients, you know, do you get nausea and vomiting and without any real cause? And that’s the Potts sort of symptom, then you do the 10 minute


standing test looking at blood pressures and pulses. And then the other one is you just do on Zoom to do the Buyten score, you know, can you build your thumb on? Yeah, can you bend your finger back? Let me look at your elbow. It takes 30 seconds. Yeah. And it’s got hyper mobile, they got parts and then my cell symptoms or every, you know, they just inflamed and allergic and Urticaria and angioedema and allergy symptoms and runny nose, runny eyes, seasonal allergies, joint pain. So for these people, still we start with the autonomic regulation, and then there’s little programs now both


Around the DNR s and the copter and this and that, but I don’t find them deep enough, quite frankly.


You don’t? Interesting. Well, I guess especially if there’s ace, I mean, if there’s early childhood trauma, they’re not they’re not going to go there. Because implies it’s sort of like it’s sort of a, an intellectual imposition over an unconscious dynamic.


And you can’t you need to, you need to make unconscious dynamics conscious, right? You only heal through consciousness, you don’t heal by just slapping things on people.


Yeah, take this take that do this go. Yeah. Well, I actually it adds more stress to the system it to some degree. And what do you know, you can’t change a negative thought by thinking of positive thought that doesn’t work? Well, not, not at that point, you can’t.


The unconscious dynamic needs to be looked at, understood and transformed.


So you need consciousness to grapple with some of these entities.


Okay, so step one, is identifying that indeed, a person is dealing with M casts, which presents I mean, I think the people with the worst cases of M casts know at this point, they have a constellation of symptoms that are inexplicable and unresolved, they, they don’t respond to anything, right, or they respond badly to things they should respond well to. So once, once we’ve hopefully gotten to a point where we’ve gotten, we’ve helped them to regulate their nervous system, because nobody’s going to do it for them, right? Like this is really helping in the individual tap into their own ability to self regulate, understand the unconscious dynamics, and self regulate, and know why they self regulating, if you don’t explain the reason, if you don’t provide salience, you are doing these exercises for this reason, because you want to end up over here. But you now over here, to get you this way. It’s like going to the gym, you have to practice and you have to get feedback. And you have to check in with your provider to see if you’re making progress with self regulation. You don’t just say, Oh, you need to meditate and do box breathing. No, it’s great relevance, and you link it, and you measure it, and you see progress that’s has to be sort of supervised and with feedback. Well, you’re rewiring the brain, right? And you’re essentially trying to overcome the dominance of your inner Darth Vader, who’s basically saying, dude, I’m just trying to keep you alive, you don’t understand.


And that’s the toughest one to rewire. Because it’s the it’s the big bully that hides behind. I’m just trying to keep you alive, you just don’t know what’s good for you.


And, and, you know, we have our default mode network, which creates our sense of self, we have our internal dialogue, we have our defense structures, we have all these things in place, that often keep us from knowing what the hidden dynamics are.


We have very sophisticated entities, with lots of slippery sort of corners, you know,


it’s not linear, it’s not, you know, we trained in n squared d squared, medicine, name of disease, name of drugs, single organ, single, single drag. It is completely without merit. When you come to complex illness when you’re trying to do whole person healing. It has the cupboard is bare, there is nothing to offer. Mm hmm. Well, which is what happens to these people, right? They’re desperate. I mean, I see them in my Facebook community, by the time they they show up there. They’ve tried everything. They’ve been everywhere. They’ve been told that they’re crazy half the time off 90% of the time, put on an SSRI and refer to the psychiatrist. Yeah. Which is, which is almost the answer, but not quite.


I mean, you know, we’re there, at least we’re going to the head, but we’re not we’re not doing it with the right intention. You also named mold, high histamine foods. These are things that can probably that I’m guessing you’re addressing while you’re helping this person to do this work, right? Because take a history of mold exposure, which is almost always in every case there. Although mold is too big, you know, it’s hidden. It’s everywhere. It’s everywhere. So you got it. There’s different ways to measure mold illness, and there’s simple quick ways which everybody falls into the trap. They do a urine mycotoxin test to say I got moldy on this. No, that’s not my that’s not chronic inflammatory response syndrome, which is a mold inflammatory condition. You’ve got urine mycotoxin. That doesn’t mean you got SIRs says is the real diagnosis you’ve got that says that you got to take a history. You got to fail the visual contrast test, you got to look at the cytokines. You’ve got to look at the IG


I’ll test for the intracellular mold species and the mycotoxins. Yes, you can do a urine mycotoxin test. But that is not diagnostic. It’s just indicative of a possibility. You got to do Ermias or hurts me twos in the home, you got to measure mold spores. There’s a lot to faking a diagnosis of chronic inflammatory response syndrome, which, by the way, is closely linked to myself. I was gonna say like, they’re, they’re kind of frickin crack the two of them, right? Because you’re, they, they feed, they feed off each other molds, a terrible trigger of miso, terrible trigger, is and it’s ubiquitous. It’s it’s, it’s everywhere. And it doesn’t mean mold in this home, it could be the mold that you were in three homes ago, that’s still in your system that hasn’t been bound up and excreted. So are there people that are more susceptible to that kind of thing? Yes. Yeah. I know, genetically, there’s genes that show that you might be like some people just their body can’t clear it somehow. Yeah, Shoemaker, Richard Shoemaker developed all that genetics around mold toxicity and inability to clear mold.


So there is a genetic basis, because only 25% of the populations are so called mold sensitive. I don’t think that big is correct. I think it’s much more well, there’s probably other genes somewhere that we just don’t, you know, there’s so much we don’t know, in genetics, but the spouse of a mold patient will go What’s wrong with you, I don’t see mold. I don’t feel mold. I’m fine, what’s wrong with you. But then the poor wife is 25% the husband’s part of the 75% they don’t crash with mold. But you know, the child or the wife’s on the floor with mold exposure. And it doesn’t make any sense because it’s a hidden toxin most of the time, for sure. When you go scratching and then you find it behind the drywall, you find it in the dishwasher, you find it behind the washing machine in the washing machine in Sangamon Bobby


in the lift up the toilet along the you know, the all that.


But you smell I mean, I smell mold. I will walk into a place and smell it and my husband will be like, I don’t know what you’re talking about. I’m like everybody smells it but


they trained dogs to smell for it. Like that dog.


I smell mold and I taste rancid oils. Other people are like, I don’t understand why you don’t like this. I’m like, Dude, this peanut butter or almond butter is rancid and they look at me like I’m crazy. And I look at them like I’m so sorry for you that your taste buds are dead.


Yeah, that’s


yeah. You could smell Molins musty for sure. Yeah, some people.


So do binders help?


In a situation like that? Oh, absolutely. They do. But the common error again, once again, there’s many errors that get made in this holistic functional world of ours. People get you know, they go down the mall. Oh god mold. Well, mold may be one of your triggers. But let’s look for everything else as well. Most the big trigger and if you do have more than you do have inflammation from mold and you have chronic inflammatory response syndrome for mold and your mitochondria undergoing cell death because of mold. Then you do have to a remove yourself, clean up the remediation and you use binders but what is taught is you use colas. tyramine is one of the primary binders because thymine is highly absorbent of all the fats and oils. So if you don’t check the fatty acid status, and you just go throw collars tyramine as a binder, that person is going to crash in front of your eyes. Yeah, yeah, for sure. And that’s, I mean, then the cause it’s funny, I have a box of it sitting there. And I haven’t touched it because I just kind of it’s one of those ones where I’m like, I’m not so sure it’s worth the downside. I’d rather take a whole lot of other stuff and I don’t know depends what what mycotoxin use secreting with a color style I mean, there’s going to be a benefit effective so you really have to do that testing to figure out what is at play here. It’s best for the awkward toxins, you know, but But what I do is I do the body by a Kennedy Krieger fatty acid test and that measures all your omega sixes or your omega threes or your omega nines, it measures your D myelination of your of your fatty acids. And you can see if your total lipid con count is below minus 30 Don’t touch call this dummy you got to crash that mission Interesting. Okay, I use the body by a fatty acid test is my one of my primary tests that I use. Oh no, I didn’t realize they had one I just there’s another company that does an omega fatty acid test but I don’t know if it says detailed that that one but you know what don’t even it’s not it’s not it’s gonna tell you tell you the only test was doing is the Kennedy Krieger test. And it measures all these fatty


He asked his body by I have developed software to interpret nice software from body but it’s not the test. The test is Kennedy Krieger. Okay, so there’s a research based lipid panel. Okay, Kennedy Krieger. Yeah, and it’s the only one worth doing. But you’ve got to put it through the body by software. Because they they give you a nice one page handout, the Omega six omega threes lipids, do this do that. It’s the software that really orientates you to the test. Hey guys quick interruption to the episode to let you in on a huge announcement. And to thank our final sponsor, a final sponsor is profound health, and they are purveyors of oral bio regulator peptides. And that’s the actual extracts of tissues, glands and organs of animals in capsules, so contains the bio regulator peptide, plus all those cofactors. And we use by regulators to help the body to regenerate at a cellular level. All of these different tissues and organs. If you want to learn more about our regular peptides, you can definitely go to the profound dash health.com website and learn more there or you can go back earlier this summer, I recorded a podcast on bio regulator basics that you might find interesting. They also have other amazing anti aging supplements, as well as synthetic bio regulators that are bioavailable just by little drops under the tongue. Now, on your first order, you will get to save 15% Off with discount code longevity 15 All right. So once again, that’s profound dash health.com. And now let’s get back to the episode. Well listen, the test is not worth the paper it’s on, if you don’t know what to do with it.


Like literally, there’s no point doing it unless you’re gonna you’re getting a roadmap with it. So or somebody who knows how to interpret it. So okay, so we we measure those, and then the high histamine foods so that this now looks like the low hanging fruit. This is the easy stuff compared to dealing with your early childhood trauma that may or may not have happened from the time you were in the womb, and then dealing with mold, which, you know, remediation is an ugly, ugly thing. Because half the time it doesn’t work like once, once mold is in that and and you know, it’s like mold is probably one of the most well adapted organisms on the face of the planet. Like it’s insidious. So let’s say we’re kind of doing what we can for the mold getting away from the high histamine foods becomes the next thing and these are the people who tell you you know you say to them what listen have some bone broth or have protein shake and they’re like,


like they go into like crisis.


Bone broth, no fermented foods, they just like crush a person overnight. And leftovers are a disaster for these folks. And I live on leftovers, but I mean like to them. Leftovers is it just is not okay. You can freeze your food and then eat it the next day, but don’t leave it in the fridge overnight. Yeah. Though, some people get away with it for 12 hours. But the very severe people they know they can’t do that, you know, so we do, but we I do paleo, autoimmune, low histamine, then adding the oxalates. And you know, the FODMAPs if they have those issues, but it’s usually paleo autoimmune, low histamine, high fat.


Right, usually replace the lipids along with reduce removing the inflammatory foods. So replacing the lipids is a big deal. And this is the body bio stuff. This is restoring the cellular membrane integrity. So let’s talk about that a little bit what those lipids are. Yeah, yeah. So I do I do the body bio fatty acid test. I do the ITL butter Conrail test that test measures phosphate title choline, and phosphate tidal ethyl Alameen. The ethyl LME is on the inner membrane of the mitochondria where your electron transport chain takes place


measures the body voltage.


So if those phosphor titled choline, Phosphatidyl ethanolamine, body volume all affected, you know, you’ve got to replace with phospholipids, then the body by a fatty acid test measures the Omega sixes, and all the Omega threes and the myelinated fats and the mega anions and the saturated fats and measures all of it. So between that and the IGF mitochondrial test, I determine what needs to be done to repair mitochondria and move people out of the cell danger response which takes three to six months to do. It’s long. It’s a long project. Yeah, but that’s but there’s a path to it. Right? And I think by the time people come to you three to six months doesn’t sound so bad when they’ve been suffering for years. I’m sure. So, so high fat so you’re saying hi, high fat have the right fat


kind of diet, you’ve got to analyze what they’re deficient in.


And then you got to replace that particular fat. So we have all these kinds of oils that have different


structures that repeat, like primrose oil for, you know, DGI, we’ve got different oils for different deficiencies. Interesting. So you just very choose your fat replacement accordingly. That’s amazing. So you’re literally kind of going at it like really like rebuilding that cellular membrane to help him to regain function. And so do you. Do you see people actually start to stabilize at some point? I mean, it sounds amazing, right? Like, no, no, it must be. It must be for these people where they wake up one morning and all of a sudden, they may not itch, or they don’t have a rash, or they get better when the test starts improving, they feel better. And they repair their cell membranes. They repair the mitochondria. They stabilize the mast cells, usually with diet and lifestyle stabilizers, which we haven’t discussed. And then they stabilize the autonomic nervous system and amygdala so they’re not so twitchy and so reactive all the time.


Yeah, so you got all the things going. So let’s talk about those mast cell stabilizer stabilizers you said, right?


So we use this nutraceuticals. And there’s you know, we use the hiss Dao enzyme, which we measure there’s tests from Precision labs, measures Dao.


There’s a Doa enzyme you can get from any genetic profile as well to see if you have and


then we look at the h&m T gene to see if you break down histamine appropriately. We look at methylation because most of method lot of methylation goes towards making phospholipids and breaking down histamine intracellularly. But what we do is we use Dao for the gut Dao, you use quercetin and associated nutrients, including vitamin C, there’s many others.


black cumin seed and Nigella sativa and luteolin for nutraceuticals vitamins, yeah, we use those. But I usually go straight to pharmaceuticals, I go straight, and I get them all compounded. Because if you go over the counter, you get all the excipients and dyers, which just make you worse, not better. But yeah, you’re talking about the most sensitive people on the planet here. So those things would destroy them. For sure. I usually start with h1 blocker. I use the h1 like levers tourism when you have to dose it twice a day, not once a day, even though it says 24 hours, not 24 hours. And if you don’t dose it twice a day, you get breakthrough history in flares. So we use h1 blocker, we use h2 blockers. And we use first generation h1 blockers at night called key Titan and keep our different own stabilizers. My sauce at NAB is also anti histamine, so you get nighttime coverage while you’re sleeping.


And then we go on to cromolyn a lot of the time. Chroma is like quercetin, it’s a mast cell stabilizer particularly for those people with food sensitivities and food reactions. And then we go on to monta, Lucasta singular, which is for the asthma, the leukotrienes. And then there’s a whole host of other pharmaceuticals you can use if you need to, but generally speaking, we get most of the work done doing that. But you know, a lot of these very sick people, I can’t take anything, I can’t do anything. And they can’t and you’ve got to bring I have to have to come to patients move to Calgary to be stabilized. We have to get them in a neutral environment. Some of our patients have developed mold free EMF free homes where people stay.


And then they stay for three to six months. And then they get IV muscle intravenous stabilization to begin with, while they’re learning self regulation. Then we add the oral supplements and my soft stabilizers while they got IV coverage.


And we’re building a window of tolerance building self regulation, lowering the amygdala building up the fats, they all speak to the nutritionist Justin Stanger, who gets them on a paleo autoimmune, low histamine high fat diet, if tolerated sometimes some people need more carbs. A lot of people need more protein as well. Yeah, but it’s all done through a chronometer, we do the eight day chronometer, we do the freestyle libera blood sugar measurements. So we get everything regulated and try and get that system to stabilize and move them through the cell danger response which is anyway as I said, from six months to a year sometimes. Wow.


And so do people. Then after this six months to a year work is done


Do they then just go on their merry way and have a perfectly normal histamine meself stable life? Or are these people often? You know, it’s a it’s an ongoing journey. Let’s say it’s an ongoing


relationship with your body and mind. And yes, they move through the cell, they’re no longer in cell danger response. They’re not shut down.


Functional, they’re back at work, they’re off disability, they, you know, they can live a life, their brain fog is lifted, they got the concentrating, they can focus, they can have energy.


And but then they always have to be hyper vigilant for being smart. They go on holiday, they go into a moldy hotel room, they go eat buffet dressed mean, yeah. Well, the more moldy hotels are the worst and you can’t screen for those. You know, the Airbnb site does not, there’s no sniff test.


People crash all the time from those sort of exposures, you know, so they always sensitive and vulnerable, but they get super educated and, you know, not to the point of neurosis, that they’re just gonna say hyper vigilant, hypervigilant, is a bit of a of a, it’s a trigger word, right? Because we just spent all this time saying they have to wait, you know, you’re helping them to retrain themselves not to be in constant sympathetic mode. So it’s conscious hyper vigilance.


They know they walk into a hotel room and it smells musty. It’s best they probably leave. Yeah. Whereas before they try and stick it out and try and please, the spouse or something, you know? Yeah. Yeah. No, they just put their foot down, honey, I’m out of here. I don’t care what we lose our deposit. I don’t care. Yeah, yeah. Because they know, well, and by then probably their spouse or their partner knows, you know, saying that you’re trying to fight this is just impossible, it’s a world of hurt, right? You’re just you’re gonna be dealing with a partner who’s unhappy and miserable, and it is not going to be a romantic holiday, it’s just not going to happen.


We always try and make sure that the value systems of both partners are equally aligned, and that the spouse comes to the educational trainings and sessions so that they get an understanding. Because it’s very, you know, if you have an avoidant spouse, and an anxious, you know, they have different attachment styles it can lead to a disaster can lead to managers breaking up? Well, for sure, and especially in a world where, you know, a lot of a lot of this type of patient gets told by the conventional medical system, that it’s all in their head. And you know, what you said earlier, you know, go see a psychiatrist, get out of your head, and you’re gonna be fine. This is and you know, and then if you have an unsympathetic or, or a spouse who doesn’t get it, it’s a family. That’s unsupportive. Yeah, exactly, it’s gonna make the problem worse, it’s gonna make you feel worse, it’s like, it’s just going to exacerbate the situation. So you know, to bring in the partner or family member or someone as a support person who can actually get their heads around understanding what’s going on.


Not to mention, allowing the person to feel safe with someone to help co regulators sort of their creators, limbic resonance and CO regulation, which is extremely important in the beginning phases of treatment anyway, you know, while people are getting back on their feet, I mean, I can’t tell you how many people just end up crying in my office, because they say, Thank God, you know, finally, this makes sense. Yeah, I’m not crazy. You know, I can’t bear the rejection by all the help prepare, whoever is trying to do the best, but it’s just not in consensual reality. The full scope of this condition hasn’t really reached the academic institutions where it’s not taught and, and used. It’s still in its infancy. So it’s a new way of looking at things. Yeah, it is. And it’s, and do you think, do you think it was around 4050 years ago or really what you’re talking about? It’s the human body was not built to deal with this kind of crap. And it’s just awesome to be exposed. There’s no question it’s an escalating condition that’s gotten worse decade to decade. Yeah. Wow.


Okay, well, let’s think on that for a minute ladies and gentlemen, and let’s pull out our self regulating devices our brain taps and new comms and whatnots are since it’s an Apollo’s I mean there’s you know, like I mean, I’m sure you see them right the number of devices that are out there right now, and nevermind people with M casts just Joe Blow walking down the street. We know that if we can help people to get out of this constant state of of activation hanging on you know, an activation I mean, if nothing else, it shuts down our immune system. It shifts to th one th


You balance goes through the roof. Yeah, yeah. No, we live in very challenging times. And we can’t take our, you know, we can’t take resilience for granted anymore, let alone all the political changes and all the cultural adjustments and let’s, let’s not, let’s forget this stuff go. Yeah, no, we can’t even go there. No. And I mean, you know, at this stage of the game, I think people are left in one of two camps, you’ve got the camp, that’s like taking up arms and saying, you know, we have to do something about this, and they’re taking it on. And, you know, we need definitely, we need people taking on whatever system is broken and trying to fix it. And then you get other people who are just kind of like keeping their heads down and going, you know, I’m just gonna keep doing what I’m doing over here and hope it goes away. But even for that person, and for both camps, the idea of self regulation, the idea of building it, and what you said it perfectly building resilience in your system, so that you can deal with, with the the incoming all the time, and it doesn’t directly affect you. And building sanctuaries, you know, finding a space that, you know, when you sleep at night, you know, bombarded by your router that you know, the amplifier that’s under your pillow, or, you know, the dirty electricity from your switch, we send building biologists into every patient’s home to measure electrical fields, magnetic fields, radio frequencies, and dirty electricity, because people with my cell activation, which by the way,


electromagnetic fields amplify mold exposure dramatically. Yeah, they have to create sanctuaries, they have to eat impeccably, they have to sleep and you know, they had to create, often they have to create Faraday cages with silver nets, and, and they have to turn off the electricity to the beds, bedside lights and turn off the routers or have kill switches to their routers. And it’s not neurotic. It’s just makes sense. Smart. It’s just smart. I mean, having it you know, we’re I’m moving into, like, I live in a very old house. And so we’re, you know, I’ve been kicking and screaming because my husband decided, you know, almost unilaterally, we’re downsizing. We’re leaving this house. And I’m like, No, I like my house, I don’t want to go. And meanwhile, I’m sitting here thinking, and if he listens to this episode, he’s going to come over, and he’s going to be seriously, you said that. And, and, but we’re moving into a home that was built 16 years ago. And these, I now I’m gonna have a lot more options in terms of what I can and cannot do in this, like in this house. We’re lucky to have electricity in that house, there will be a breaker that’s associated with the room. But I can tell that it’s not a smart home was rigged up to me. It’s not. No, it’s not. It’s not that. I mean, and you know, it’s interesting, right? Smart Homes, electric vehicles.


All of this, like somebody who I think we went, Oh, yeah, we went in to get buy a dishwasher and a washing machine and a dryer. And they’re like, Oh, guess what, you can get these smart electronics, and you can program it from the car. And I’m like, why would I even want to do that? Like, why would I want to bring more of this into my life? I don’t need to tell my dishwasher to turn on when I’m in the car. I can turn it on when I get home. That’s what buttons are.


I do believe that we will evolutionary adjust to the incoming toxic load and develop some resilience in our genetic machinery.


I like that line of thinking, Yeah, I don’t think we’re doomed to sort of be extinct because of the incoming toxic load. I mean, even yes, we’ve had periods of extinction. But there’s a sort of, you know, that whenever we support whenever we challenge, there’s always an adjustment that we make, and we develop genetic mutations. Unfortunately, it is, you know, the strong survive and the weak guy really does amount to that, in the end, the ones who have resilience, good gene pools, you know, they stay healthy, and they they survive better longer. But we do have to adjust a whole new mental healthcare model of well being as opposed to disease can rise to the host shifting consciousness and an awareness of environmental toxins and all these things. It will come it’ll come. Yeah, no, I agree with you. And I do think that there’ll be and your I’ve heard it from a couple of people, this whole idea of, you know, eventually nonnative EMFs acting as a hormetic stressor, as long as you’re not one of these electrically sensitive people. If we have healthier membranes, if we’re eating better foods, if we’re, you know, if we’re taking care of all those other things, and limit the toxins, all those toxins, whether it’s stress or EMF or food


and just give ourselves more buffer, human beings have value systems, you know, we have relationships we have


have social connections, we have health and well being. We have mental health education, we have careers, and we have the making of money. And then we have our spiritual calling what we meant to do, we have to raise health as a very dominant value across the board. We cannot take your absence of disease. Forget about that’s not health. No, yeah, we know that. So when you know, people come and see me for wellness, medicine, you open the hood, and they just rife with all sorts of metabolic imbalances, you know.


So yeah, so we’ve got to emphasize healthcare. And we emphasize food and emphasize nutrition and stress response and sleep and exercise and flexibility and movement, that must become the new model that we will work towards the disease care model has had its day. And we don’t want it to go away, because we still want a day when we get diseases. But we’ve got to replace it with a whole new paradigm that’s has equal clout and validity and consensual reality. And it’s not, you know, oh, those hippies over there, they know, this is real, this, we’ve got to raise health as a value system and make it stand alongside disease care. Well, and I think to do that, effectively, it has to it even has to be taught in schools, like it needs to be woven through the very fabric, like little kids, like a man, you know, like I’ve and I know this one, I’ve worked with families as a nutritionist, and when the little kids get on board, and they are like the Secret Service, these kids are relentless. Like when you get them on side, nobody gets destroyed. And they’re awesome. But they have to be empowered and taught and, and given the tools. And the next wave was, you know, this whole Surgeon General of the United States issued some thing two days ago saying the exposure to social media electromagnetics is definitely impeding children’s mental health and well being. It’s, you know, it’s gaining momentum, because lobbyists are fighting against all of it. So it’s a very, it’s a big struggle,


maybe a century to evolve into a new paradigm. But yeah, it will eventually get there. Yeah. And it comes down to the individuals, right. I think different parents, it’s up to parents to make, make different choices for their kids not buy them a cell phone when therefore. And you know, those things, but it’s going to be a process and but there’s hope, right? I mean, that’s the good news. And the good news is that, you know, for people with M casts,


there’s a sense of desperation until they come across people like you, doctors, like you who, you know, it’s not like you have all the answers, but you sure have figured out a bunch of it, and you can help them to get to a place a better place. Yeah, absolutely. Yeah. This patient I saw this morning had no clue she had pots, not only she had pots, she has a misoperation for foods and reacting to angioedema, urticaria reactionary said, Are you dizzy when you stand up? Yes, I think I have pots. As I was told some time ago, I had pots. She did a blood pressure she had like pots, like the worst case I’ve seen in a long time. And she just started putting more salt in water in her diet, and she’s feeling 50% Better, just one little thing. Now pots isn’t well recognized. Either. We don’t use that, well. 10. There you go. For a tilt table, you don’t need a tilt table test. You just do 10 minutes of your blood pressure lying down. You lie down for three minutes, take your blood pressure pulse stand up for one minute. Take it again with the Omron you know, three minutes, five minutes, 10 minute. If your pulse rate goes up over 30 beats per minute over there 10 minutes, or over 120 At any given time. You got Putz? Really? Yeah, oh, if your systolic blood pressure drops more than 20 You’ve got orthostatic hypotension. If you don’t treat that you won’t fix your muscle activation.


So pots comes right up front and center. And is that because it sends a stress signal to the nervous system like shits about to go bad? And therefore that puts you in that fight or flight? Like it drives anxiety? Virtually right? Anxiety it drives it’s better if you don’t perfuse your mitochondria and you or your brain because then there’d be that Yeah.


You get hypoxia hypovolemia you feel awful.


And they walk around sort of dizzy and can’t stand up and feeling faint and palpitations and pots is ubiquitous, especially amongst that phenotype I mentioned. Yeah, yeah.


Okay, well, we’ve covered a lot of ground sir


Yeah, it’s, I love what I do. And it’s very pleasant when you finally can help a person put some foot on the ground and stabilize the imbalances and provide insight that my colleagues in traditional medicine, having come from medical school, we just don’t learn this, you know, postgraduate exposure and interests of mine. That’s why I know it, but I was gonna say what sent you down this path? Like, how did you get here? Because, uh, you’re, you’re classically trained MD, like, you’re you went to med school.


I was interested in as a young boy and what? How did people become the most evolved? They could possibly be? So I was always curious from a very young age. What does it take to become self? actualized?


Young age? All right. You’ve been around a few for a while. Okay. I read your um, and I read about individuation self. And then I got exposed to Indian, you know, philosophies and things. So when I became an MD, I was like, these people are presented with all these senses. But who are they really? And who do they wish to become? So then I started to just just examine everything that could possibly help a person self actualizing become who they meant to be. And that led to every single, you know, ology in the book, I got to go study everything I still study. I just came back last night from Ozone conference learning.


Yeah, ozone is a very interesting, very interesting area, especially when you’re trying to, you know, reduce toxic load and a person and treat mitochondrial issues. Yeah, yeah. Yeah, I have that podcast, and you have to


stay curious. You just stay, you know, close to the end, you listen to your patients? Yeah. Well, I mean, you know, you said one thing earlier that not a lot of I mean, that, you know, in the conventional system, there’s no space allowed for this anymore. And it’s that whole, taking down medical history with the patient. And, and, and that can that takes time. But the person taking the history has to be exposed to a very wide range, there has to be a new curriculum of, of healer, who gets exposed to a very wide range of ologies and sciences and methodologies. So that when they sitting in front of a patient, they can go up and down layers and levels of healing, not just work with biochemistry and mechanistic medicine. They know if there’s inherited trauma, if there’s early defense structures, if there’s, you know, they can tell just by taking the history, that the diagnostic pellet has to be very broad. Yeah, don’t be trained in n squared d squared medical school only, they have to be curious about the human condition. Yeah. And they have a curriculum that’s exposes them to some of the core tenants of the of what it takes to diagnose and treat a complex patient. Maybe your next job, she needs to be like starting a new med school or some kind. I’ve written my book is the new curriculum I’ve written again, you have, yeah, I should have that book published. Well, when it’s published.


Okay, at some point, you’re just gonna have to put your pen down and send it off to the publisher. And you can always do a version two, or an addendum.


But as I sit down on a Friday night to start a chapter for revision, and then I get, you know, a new podcast to listen to or something. Yeah, no, yeah, yeah. Okay, you know what, you’re just gonna have to give us what you got. And then you can always just give us more.


For an idea, no, I’ve written this book, the new curriculum, seven stages to health and transformation, a new medical curriculum. And that is the title of the book. It’s based on the layers and levels of healing, and how you need to amplify your diagnostic and therapeutic template. And I do wish to eventually have people fill in all the gaps of all the layers and levels that are created, and then create a new curriculum for a new healer, or a new a new way of approaching complex illness. Yeah, well, I think that’s brilliant. You just, you know, the way to get the ball rolling, though, is to put that book out.


I’ve done small versions of it. All right, whatever.


chapter by chapter, if you have to whatever.


All right. Well, Dr. Hoffman, I thank you so much for today. Is there anything else that you’d like to leave the audience with? I mean, you’ve you’ve dropped a lot of wisdom on us, but yeah, anything else? I just, I just, you know, I don’t know if there’s anything else to say but don’t. If you’ve read for patients, or anybody who’s hearing if you don’t be tempted to find the latest diagnosis, the mole the heavy metal, just be careful of that. It’s usually that plus 50 other things. That’s number one. Number two, you your body is the final resting place.


Not only of your own experiences, but your ancestral experience as well. So it may not have started with you, which is the title of one of my friends bookmark Walden, who did family work. So it may not be what you think it is. And there may be a complexity that you haven’t even imagined. And don’t lose hope, because you will find the heat up. If you stay curious and you stay open, you will eventually, hopefully, meet up with somebody who can assist you on your transition path, you know.


And so in the meantime, you may have to deal with an you know, somebody who’s got a little piece of the puzzle, hopefully, over time, you can expand and meet people who got a bigger piece of the puzzle, who can see the whole you and institute a whole person healing, not just parts are not just SIBO, or not just Lyme, you know, you really, really need to have a very broad diagnostic palate, when we’re sitting in front of a person and listening listening to what they’re trying to tell you. Yeah, yeah. Well, I actually interviewed a practitioner last year. And she said, you know, almost without fail, the patient has the answer. Did you have the lucky. They know, like, they know everything changed when or things have never been the same since or they it’s just the taking the time to like, in her case that you know, she had one patient, she wasn’t getting anywhere with her. She went back to her pages and pages and pages of notes and came across this one thing and said, Oh, I missed that goes back, talk to the patient. And boom, it turned out to be a turning point for for the practitioner and for the patient. And patients are very educated. Now. They all have a Google and whatnot. And they will come in and say oh, have you thought of this? Have you thought of that? What about this? And nine times out of 10 day in suggestions are completely spot on. Interesting. Interesting. Body, right. Oh, I gotta talk today. I have a salt supplement for parts that I hadn’t heard of. So I go look it up quick. Yeah, he was right. Is that is a better option. The one I was using. There you go. And there’s people making stuff all the time. Right. So there’s always something new.


All right. Well, Dr. Hoffman, where can people find you Ben? When Calgary, Calgary. So Hoffman center. Your website is Hoffman center.com.


Oh, come on.


I think if you Google happened center, it comes up. The title is Hopkins Center for functional and integrative medicine, but I don’t think you have to put that in. It’s just open center. Okay. Perfect.


in Calgary, Alberta. This is in Canada, folks. No, this is not a US doctor with this is one of our own in Canada. Very proud of him. So thank you so much for your time and for sharing and we’re looking forward to the book when you decide to share it with the rest of us. Get it out for sure. Thanks. Thank you. Thank you. Okay, bye bye. Thanks so much for joining me on this episode of The biohacking superhuman performance podcast. If you enjoyed the show, please remember to leave us a five star review on iTunes, because that’s what helps us to be heard and to be seen. If you’d like to connect with me directly. Or if you’d like to leave any comments or if you have any questions about MCAS or this episode, please reach out to me directly through my website, Matt agnitum.com. And of course, if you’re not already a member of the biohacking to superhuman performance community on Facebook, that’s where you’ll find me every day. It’s a short application, just answered a couple of questions and you’re in and interfacing with other amazing biohackers thanks again, and we’ll look forward to seeing you on the next episode.

Solving Chronic Health Problems, Adrenal Fatigue & Mitochondria

Solving Chronic Health Problems

In this talk with ​​Rachel Jennings N.D of Heal Yourself Institute, we discuss how to solve chronic health problems, adrenal fatigue, and mitochondria.

This transcript was automatically generated, please excuse any errors.


Hello everyone and welcome back to the high energy woman online event where our vision is to help women step into their power to heal, to supercharge your energy and to break free from feeling burnt out. We really hope this conversation will inspire you to take action to live life with more passion and more purpose for the things that are meaningful to you. Today, I could not be more excited to highlight Dr. Bruce Hoffman. Dr. Bruce Hoffman is a Calgary based integrative and functional medicine practitioner. He is a medical director at the Hoffman Center for Integrative Medicine in the brain center of Alberta specializing in complex medical conditions. He was born in South Africa and obtained his medical degree from the University of Cape Town. He is a certified functional medicine practitioner is board certified with a fellowship and anti aging and regenerative medicine practitioner, a certified Shoemaker mold treatment protocol practitioner, a certified Ayurvedic practitioner, as well as certified in Family Constellations, and eyelids trained in the treatment of Lyme disease and CO infections. He is the co author of a recent paper published by Dr. Alfred’s group diagnosis of mast cell activation syndrome, a global consensus. It’s quite the bio. And it’s quite demand. So I’m super, super excited to be chatting today. Dr. Hoffman. Excellent. Thanks very sure. I always like to start, the first very first question is very apparent, it’s a personal question.


Really just tell us your personal journey that led you to do the work that you do today.


Um, the personal journey Well,


I never came to medicine. The I didn’t come to medicine the right way. I, I was interested in literature and poetry and thing arts. And I was actually employed by the circus and by an opera company, when I got a phone call from my mother, this is after I graduated from high school. And she said, Oh, by the way, you got into med school. And I said to her, What are you talking about? She said, Oh, you didn’t you know, I applied for medical school for you. Oh, my Wow.


What are you talking about? Well, there was a scholarship and I applied and you got in. So you start med school in six months.


And so I found myself in med school scratching my head when not knowing what on earth was going on. But it’s, it’s the most


the best serendipitous event on my lap. Because when I was a younger boy, before that I was I learned a lot about philosophy and religion, and poetry and literature from a high school teacher of mine. And he exposed me to the arts. And that’s why I wanted to pursue the arts. I was sort of geared to do that. But once I went to med school and learned to become a family physician, and then started to study Chinese medicine, I have better I was able to bring all my love of arts and poetry and literature into the process of working with complex illness patients. So I was able to finally marry my love of medical arts with medical science and do what I do today. So I thank my mother for getting me into med school.


Hell, I was doing this for years. I was like, What the hell is this?


Well, I guess maybe you’d be like a circus performer still. So it’s amazing that you’re doing what you’re doing today. But I couldn’t I love my life. I love my work. I love my page. I love I mean, just 15 minutes ago, you very kindly allowed me to prolong this interview because I was just on a, you know, another conference.


As you know, you never know enough you always feel ignorant. You keep studying and studying and studying and never getting ahead. It’s just an ongoing issue. I’m 65 now and I you know, I love what I do, and I love learning more and more all the time. I think that’s the true definition of a great doctor is constantly learning and innovating and changing selects amazing. I counted last month. I’ve attended 278 conferences since since 2007. Oh my gosh, I love that. I love that


you probably a couple of assistants that you’re probably got all the time right attending conferences.




that’s so great. Um, I know you have so many talents we really talked about, you know, you dealing with lyme patients with Lyme and mold and chronic illness. If we could start off really talking about histamine, and really giving people just a brief explanation of what histamine is and what it does in the body. Sure, sure.


Well do talk about history, what is step back a little bit and talk about the so called mast cells that everybody now my, my South African accent gets, people say, what do you do? So, I think the correct explanation and mast cells, they say, in masks, yeah. So, my cells are these little they 1% of the white blood cells, and they vigilante cells, in the sense that they sit on the art on the interface between outer and inner environments. And they also reached the innovators and multiple tissues in the body, the brain, the brain is richly integrated with myself. And they release the contents whenever they become provoked.


And they release over 1000 mediators of inflammation shook tazers, the last days is all sorts of proteases. And they release histamine. Histamine is the most well known the most common, and the one which usually gets people to start thinking that whether they have sort of a histamine intolerance to versus a mast cell activation syndrome. And a mast cell activation syndrome is is characterized by those individuals who not only have histamine release, but they have inflammation in general. And they also may have a whole release of growth factors as well. So it’s not just the histamine that gets into the practitioner. It’s this whole cascade of multiple symptomatology and multiple organs. That sort of fits the criteria for what we call consensus to criteria. There’s two criteria for the diagnosis of mast cell activation syndrome. There’s sort of the original, my consensus one by Aiken, which said you had to have this tryptase Elevate, after a flare. But we in the consensus to the Efrain group, we say that you just need a whole constellation of symptoms that respond to treatment. And if you happen to have an increased


set of lab data, that’s all to the benefit, but they’re not essential for the diagnosis of my cell activation syndrome, whereas the consensus one the more stricter criteria, so you’ve got to have that chip days increased to make the diagnosis. So you’ve got these two sort of standards of care, so to speak, and many things in medicine have two different standards of care. As we know, like Lyme disease, the IDSA versus islands, there’s two standards of care as it is with myself two standards of care out there right now. Hmm, interesting. So I was gonna my next question was going to be about mast cells. But we covered that a little bit. So what what do you think triggers the release of histamine is good in the body? But what triggers the excess? And the issues created with too much histamine? Well, that’s a fantastic question. Because the answer is


look around


you know, anything that’s a bloody pus, you we have a homeostatic mechanism, and anything that the body can’t hold me aesthetically, self regulate, will then create an escalation in the ability to regulate and has the potential then to trigger muscle activation, anything, it doesn’t matter whether it’s physical, electromagnetic, mold, lime infections, or thoughts.


We have 60,000 thoughts a day. And every, every, you know, Deepak Chopra made that statement famous, he said, and then, you know, 90% of the thoughts we have today are the same as yesterday. And so we self perpetuate our internal dialogue creates a sort of chemical messenger cascades that then triggers receptors on every cell in the body, which then turn on DNA and messenger RNA and, and then that lead to the expression of my cell activation, if you will. So, our very thought processes and that brings into account you know, the whole


people who’ve undergone particular traumatic experiences and traumas the big catchword now but it’s incredibly real people with


Early adverse childhood experiences seem to have a much harder time in the ability to self regulate their disability, inability to self regulate the OIS isolating and waxing and waning between sympathetic overdrive. And what we now know as dorsal vagal collapse or small dangerous bonds when the system just gets overwhelmed with inflammatory triggers and just shuts down. And that’s the basis of many chronic diseases and many people who stuck in the cell danger dorsal vagal response can’t get out


of perpetuating these inflammatory cycles. And, and that’s who we see, I mean, those of us in this field and there’s many, many of us


those are our patients and they don’t feel they don’t fit the you know, n squared d squared criteria name of Disney’s name of jug is just forgetting that playbook got that’s yeah, that’s that’s 30 years ago thinking I


really love that you brought it Robert navios cell danger response because we talked about that briefly on the on the event about mitochondria and things like that. So I love that you really brought that in. I think that’s the missing piece. People don’t really realize that histamines and then just an inflammatory condition, ya know, that my the mitochondrial shutdown is the probably if I had to, I work in layers and levels from Spirit to toxicology based on Ayurvedic model. And


the, if I had to look at level two, which is the biochemical piece,


the mitochondrial destruction, mitochondrial autophagy, and cell danger response is probably the deepest insight we now have as to why people get stuck in these inflammatory cycles or cancer cycles


because the cell danger responses different cell data one, two and three, these different levels of you get into the cell inflammatory response, then you get the proliferative, then you get the repair. And there’s different diseases that different sequences of the cell dangerous bone, and all we see right now people shut down and


just not running just and with COVID Oh, my goodness, me. Here we go. Yes, the viruses just totally burned out. Yeah, it’s interesting what you saying that histamine? So um, I know some people do. I don’t know if you do clinically do LDA or LDI therapy in your office? No, but um, you know, type of incident. I think he’s on your Summit


is the great sort of proponent and expert in that field.


I did his conferences, and I’ve done a lot of LDI LDA courses, but you’ve got to have a number of staff to sort of help you coordinate it all. And I’ve already got too many stuff.


Yeah, I’m trying to go fishing not make more work. I think you’re trying to go to another conference is what you’re trying to do.


Yeah, I serve I don’t fish. Sorry.


Yeah, no. So that that became a sort of stumbling block, but I wish to goodness, I mean, some of my greatest colleagues do fantastic work, they use LDI. And I think it has its place, but you know, like anything monotherapies, without the, without the algorithms, and all the interlocking bits and pieces. I’m not a big proponent of monotherapies for anything.


I get patients phoned me up and say, well find my stuff and they want, I’ve got mold. I want to I want you to prescribe colas, tyramine and then Alright, fill out the questionnaire, we’ll do a two hour interview. And we’ll see what other issues are co morbid or coexistent. And this usually 50 other issues that play the mold diagnosis is just somewhere in there, but it’s not it. And, you know, we spend our lives trying to sort out people’s beliefs about what they have and what may be truly going on. And even then it’s we sort of pushing a mystery into a mystery. Yes, we do know certain things. We have landmarks, we have ability to objectively measure


or moving towards the strange attractor of who knows, right? Everybody’s so individual, right? Like now your data, everything, it’s just bio individuality. The only thing the only thing that the only thing that stays true is that is if you keep asking the questions, and you keep in dialogue with your patient, you have to stay present to what they telling you because, you know, there’s this now this whole concept that’s been introduced that if there isn’t ever


evidence for what the person seeing then there must be only in their mind


that that paradigm is given the recipe that must be stemmed out, you know, that’s just ridiculous. And patients are, you know, I’ve yet to see a patient who lingers or who’s a hypochondriac. No, they just may have a heightened sympathetic drive, and they may have increased anxiety neurotransmitters, but that’s a byproduct of the entire Gestalt that leads to that expression, it’s not that they have a DSM five diagnosis of


some sort of psychiatric condition. It’s, it’s the, it’s the in our bodies are the endpoint of our entire lived experience. Mm hmm. And that’s how we’re gonna get filtered through ancestors. And


then here, we sit with this, you know, this finite, which is not finite, but the so called finite system that’s not expressing expressing either wellness or disease. And we just got to be humbled to the mystery and listen, listen, listen, and, and, and try and interrelate with what we’ve been told and what what’s being exchanged, and then objectively measure, and then build from the basement up what we can, you know, do you ever see patients come in who tried all kinds of different things for mast cell? And let’s just say they have puffy eyes running, you know, runny eyes, histamine issues? And, you know, just nothing works?


How do you like, what’s your kind of philosophy on treating those patients that they’ve tried everything? And just nothing seems to be kind of shutting off that response? Well, that’s a complicated question. Because


first of all, when you’re working with complex illness, and people who have my salary activity, one of the first things you’ve got to do is to stabilize micelle expression.


And that can be whack a mole, like in nature, because there’s, you know, there’s 1000 Different mediators. So which one do you work, you know.


So what we try and do is we try and remove as many triggers of the micelle exposure. And my cell expression, of course, food being one of the most


one of the huge drivers of my cell activation, particularly in the gap, which then leads to a whole cascade of immune dysregulation and permeability issues.


So we, we try and remove what we can, and then we stabilize mast cell activation. If you find that somebody, and then you try and restore the cell danger response, you’re trying to work through mitochondria and immune dysregulation, and hormonal and you’re the whole cascade, if you still struggling,


very often those people have ancestral or early developmental trauma.


You’ll see that all the time, you know, and I then I use another colleague of mine, whose name is Mike Walden. And he’s written a book, it didn’t start with you.


It’s all about inherited ancestral and early developmental trauma and he has a gift of being able to in two hours work out the the antecedents, mediators and triggers of hyper reactivity to internal and external influences. And many of these people have tragic, you know, ancestral inheritances or early developmental traumas, never seen never heard neglect abuse traumas. And then there was heightened sympathetic amygdala overdrive with dorsal vagal you know, with the vagus being realized they always in the sympathetic adrenaline noradrenaline, which activates histamine


and so unless you down regulate that system,


you always going to be whack a mole in the micelles and, and it can be you know, there’s that Toby this video I don’t know if you’ve seen it of a guy who gets on a bicycle. And he you and he turns right the bicycle goes left. And so it’s it’s this video, it’s on YouTube, you just read backwards bicycle just typing.


And this guy, he thinks it gets on the stage. He says, I can do that and he can’t and it takes him nine months to learn to ride the bicycle the wrong way around.


That’s probably the whack a mole you talk about right? Well that’s the neuroplasticity in order for people to reprogram you know they in their belief systems, the internal dialogue their defenses, they downed wood expression of the you know, when we look at brains of people who have been through


aromatized you can see this heightened beta brainwaves and low alpha and increase theta. To change through neuroplasticity, it’s, it’s literally like going to the gym, you’re not going to get big biceps. So I just doing a couple of, you know,


biceps, cause you gotta go for it and the same changing for people who have not learned to self regulate very well, to learn to self regulate and be in their bodies, and not dissociate and fragment or resist or project and not have this very rigid defense system that keeps any therapeutic intervention from being taking hold. That requires a lot of heavy lifting. A lot of neuro biofeedback and we refer to Somatic Experiencing practitioners to do fabulous work body workers. There’s a whole cascade of different people on your team to try and assist people deal with traumas down regulate their brainwaves up regulate the vagus tone, feel their bodies, be in their bodies know when they go out of their bodies know when they’re dissociated. Know when they fragment, learn the attachment styles, learn the eye or very profiles, learn the Myers Briggs learn, know yourself, you


I love that you’re going here. And then not take yourself too seriously. I’m thinking of Annie hoppers work with a limbic system and, you know, being vata or Pitta or Kapha. And I didn’t know that stuff you’ve got if you’ve thought, or you, you know, your Vita and you go on a Pitta diet or Kapha diet, it’s toast.


And if you don’t know your attachment styles, and you don’t know your Myers Briggs styles, you’ll be blaming yourself, you’ll be sort of beating yourself up. And meanwhile, it’s just a sort of a constitutional preference that you’re going to born into. Learn to modulate those behaviors when you get to know yourself.


I love that you are Vedic principles there. Oh, I use them all day long about it when a patient walks in the door immediately does instinctively have to know if they buy to Peter Kafka because of either patient, provider patient, you know, they’ve full of ideas, and they implement your ideas for short periods of time, and they get bored and they want something new.


And they always react to everything. Of course they they always you know, my Sally? Yeah, that would be me that would be mass selling.


And then the pitches are, you know, the more aggressive fiery types always you have to be on time and if you late and they get mad, and they blame you if things don’t go well then you got to be the best in the city or the best in the country. Otherwise, you’re not good enough and your waiting room must be tidy and must be nice chairs and


probably not a pig. Ah, are you?


Well, I got Peter in, okay.


puffers are more sweet. You know, they the earthen water they, they tremendously sweet and loving and kind. They’re very kind. They’re very loyal. They,


they do every, you know, they, they come to every appointment, and they are very nice and very kind. But they, they very difficult to budge. They don’t,


don’t do a single thing you ask them to do, but they come back, they come back to the next appointment.


I love that you brought personality types and constitutional types into this because I think like you said, it’s really the underlying, you know, factor about how people are going to respond and what they’re going to do. And if you if you treat, if you even Myers Briggs, if you treat, you know, an extrovert a certain way if you don’t read them, right, or thinking type, or feeding type, oh my goodness, you get a feeding type person wrong. You’re like, Hell how?


Yes, it is. Most of us doctors are, you know, thinking types. And so when we when we, when we download our database on a feeling type basis is like, what the hell is right? Yeah, but doctor, that’s not how I feel. Okay.


Yes, I’m definitely feeling tight. So I actually don’t know a ton about the Myers Briggs. I’m gonna look into that about the concept or those constitutional types are feeling tight. It’s interesting. They pay us draw Hmm. So you talk a little bit about diet being so important. So I know you know things you know, high histamine foods like tomatoes and what are some of the


Super, super high histamine foods that you would have people avoid even just for a short period of time leftovers for sure.


The protein histidine breaks down to histamine the longer you leave it particularly in fish, you know,


there’s a particular disease Grom broad poisoning, which is eating old fish. It’s a histamine reaction, you get the red face and everything. Go to er think you like when you take nice and you get the red face? That’s a histamine flush. Same thing. Yeah, Okay, interesting. Yeah, yeah, I do.


Citrus is big.


is a big one. And then all the yeasty foods, of course.


I have a we have a cheat sheet. One, one pages, all the things you can eat. And then the other pages will things you can’t even eat. You know, we’d combined paleo autoimmune, low histamine, because the Paleo autoimmune diet lowers the inflammatory component. And then we start to subset it into low histamine, low FODMAPs, low oxalates bla bla bla. So you’ve got to know all those diets, you got to know all the diets, the lectin diet, the low lectins, you got to know them more than you got to know how to use them or


they’re interested. If you don’t know those diets, you can’t really you can’t work with patients with the multiplicity of presentation, because you’ll get all types all kinds, you know, I oxalates, high salicylates. Hi, FODMAPs. Hi. So those are all all in the same patient, then you got not much food list, right? Yeah, maybe yeah, I would say a beat or something.


Yes. And then in many people have that heightened amygdala, you know, they have early trauma, where the amygdala is highly sensitized. And the mere thought of the food will trigger my cell reaction, they don’t have to eat the food.


Just the thought will trigger the response, because the amygdala is just firing all the time. Yes. So you talk a little bit about the foods do you do you use any certain nutraceuticals that are really good I’m taking core certain are things that really down regulate the histamine response, one of them.


Oh, wow, that’s a lot. Everything and anything that works from vitamin C to quesiton, to Dao to luteolin, to like cumin, C to PE A, the I have, like 30 that we could potentially use but I, I tend to use his Dao natural D history as my foot one two punch. And then I use Barbara protect or quesiton and then I start going down, you know, PE A, you know, all the rest of them. Okay, I use I use pharmaceuticals a lot of the time to Oh, interesting. I prefer pharmaceuticals in the beginning stages of complex ill myself patient because they work and they get they just calm the system down so you can get things done.


h1 h2 blockers and mast cell stabilizers and anti leukotrienes and like singulars I use them liberally. Wow, okay, interesting.


No shame and no fear just


just for a short period as long as it’s needed long as is needed while you regulating that system. Remember nine months to change neuroplasticity to change the system? Guy minds. Wow, it takes a long time I patients asked me how long what’s my prognosis? Doc, I say


I have no idea. However, on average, it takes about six months to a year to get the mitochondria to your you can’t put


this pathogenesis there’s disease and they Salya Genesis that Nivas spoke about healing and what caused the disease is not often what heals the disease. And you’ve got to really put into that cell danger response you got to put in the healing nutrients and all the missing building blocks of which there’s 50


Kind of, you know, you got to remove the pathogenesis and you got to put in the healing nutrients and, and that’s process a lot of them are fat soluble and fat soluble nutraceuticals they, they don’t they don’t want to be pushed upstream they want to be is you got to sort of seduce them into place you know? Yes, yes. That’s interesting. I know. Dr. Clean heart talks about parasitic infections and that’s one of this where he sometimes where he starts because that can also cause that as well. Yeah, he’s he’s big on parasites is one of the primary drivers of these chronically stuck people. Very interesting. So if you’re


Okay, we’re switching gears just a little bit. Um, do you treat I wanted to chat with you a little bit about adrenal fatigue or cortisol issues, since like the conference is really all about women, you know, with energy issues and burnout and brain fog. And do you treat that in your office? I’m sure you do.


Do I treat anything else? I mean,


the adrenal cortisol, you know, the HPA axis is sort of secondary. It’s a driver of this whole cascade of mitochondrial shutdown. Those are the it’s not you know, people say Oh, I went to see my naturopath I got adrenal fatigue, no, your adrenals are fatigued because of a constellation of multiplicity of factors that are just pushing your system into the shutdown cell danger response and the adrenal the adrenal issues a subset within a subset you know, you got to you got to pull out like as a stupid saying is you got to you know, grab 30 nails in your feed you pull out as many as you can. But if you only pull out 25 You still got five it still hurts. So the adrenals will correct once you reduce the allostatic load once you start taking the bad things out and repairing and balancing the system the adrenals will self correct


the adrenal issue I think is a very much a secondary issue and I I measure the cortisol awakening response of measured on measure serum cortisol in the morning pm ACTH saliva cortisol 24 hour urine cortisol urine cortisol metabolites, measure them all but I don’t they all self regulate once you start to write the ship


they come back on board when the system is more regulated. When you say right the ship do you mean down like down like regulated nervous system? So it’s not constantly in a sympathetic state, though the whole the whole, you know, the whole person, okay, hormones, you know, mold whatever early ancestral trauma belief systems defense mechanisms, early developmental trauma, structural problems, brain autonomic nervous system vagal tone, nutrient deficiencies, micro macro, removal of toxins, removal of heavy metals, removal of infections, removal of parasite,


the whole concept the whole saga of life


seems like quite a bit, right? What is it? We’re looking for one thing, but apparently it’s not. One thing isn’t.


Do you think hormones like low progesterone or you know, any issues with hormones play up play a major role, huge.


hormone dysregulation is is always at play, you know?


Woman fourth woman, particularly the estrogen progesterone ratio. I mean cortisol, you talk about adrenal cortisol gets made from progesterone, and progesterone regulates estrogen. And many women have estrogen overload you designer by Zenner, estrogens, weight and so forth. And so, estrogen progesterone dysregulation with PCOS and hyperinsulinemia those conditions are epidemic.


And hormone regulation is crucial, which is one of my postgraduate things is hormone therapy. Okay, do you do saliva or blood or urine dried urine for hormone testing? Are all your


saliva and urine all three at once? Interesting gametime because hormones are bound to proteins in the blood. They then get dropped off at receptors saliva, and then they get metabolized through genetics and organs urine. So you gotta measure all three components to get an idea where you’re at. I shudder when people come in with a with all due respect, a Dutch test and say, you know, this is I’ve got this No, you don’t necessarily let’s look, you know, let’s look at the blood. Let’s look at the saliva. Let’s look at the urine. Let’s take your history and then work it out. You know, what is your insulin doing? What your LH FSH doing? What you know, what’s your hemoglobin a one C? What’s your freestyle liberal showing with your blood sugar? All of these interrelated factors have to be taken into account to take single hormones and just replace them. I gave that up 20 years ago. Don’t do that. Yeah. Wow. That’s interesting. I haven’t heard that strategy. That’s amazing. So I want to ask you quickly about cell membrane health. Um, do you use things in your office like faster time


choline or I know


there’s some other things some other lipid replacement do you use those in your office? My middle name is phosphor title


wow I’m thinking of plasma and plasma halogens I guess word yes. Yes. Okay.


Yeah so we do you know we do the body bio fatty acid test, we do the IgM mitochondrial test, we do the David good enough plasminogen test. I had the good fortune of working with Justine Stanger, who works for body by and Dale good to know the plasma origins and she’s an excellent chef and nutritionist and health coach. So we have can objectively identify fatty acid deficiencies, mitochondrial destruction, all the toxins that are sitting as adults on DNA and on cell membranes. We can measure cell membrane voltage cell membrane phosphate title, choline, phosphate, tidal ethyl el Amin levels, we can measure Plasma halogens, and you just look at those and all of a sudden, everything starts to make sense.


And I really use that as my baseline the you know, I use the ion panel from Great Plains from Genova for the macro micronutrients, I use the methylation panel from health diagnostics, or use the body by a fatty acid per AGL plasminogen plus then the hormones and everything else but those become my coal panels to look at what’s going on at this cell membrane, mitochondrial level and those until those get repaired the job’s not done.


Very interesting I did a body biome I think was from Meridian Valley labs years ago. I think what body bio first came out at least that portion of the company


but yeah, that’s been a huge game changer for me as well. Fatty Acids crucial crucial the body bio fatty acid, which goes to Kennedy Krieger but they put their software


that that tests wow, I mean, that’s changed lives. People come in everybody’s fish oil overloaded they all got


you know, they Mica 60s. Oh, shut down. Yes, I was gonna ask you if you use fish oil, but I assume that’s a big no, I take people off fish all day long.


But I use it when it’s needed. For sure it is needed. Okay, everybody’s taking fish oil, mica three saturated


and Amiga three shuts down Vegas six shuts down. A lot of the cell membrane precursors or the Omega six fats are necessary to make


phospholipids with great integrity, and arachidonic acid for immune regulation. So if you overdo your omega threes, you got immune issues and you’ve got cell membrane issues.


I’m thinking all the autoimmunity out there people are just you know, wow. I love that you start there. Um, I wanted to ask you about I don’t think people really know what plasma halogens actually are. I just recently learned of them. So what’s a like a kind of an elementary explanation of what they are? Well, as I understand them, they sort of the end products as phosphate, phosphate lipid production, and they modulate the immune response, and inflammation.


Dr. Goodenough, who’s a Canadian, Saskatchewan by chemists sort of put them on the map.


And he’s manufacturing them from some obscure gets him from Ukraine or China or somewhere, the raw material and then he makes them and he’s fact in his facility. I’ve only recently started doing the test and with Justin’s help, sort of learned how to plug it into clinical practice.


But it’s a sort of recent, recent progression in my work, it’s only the last six months, so don’t have a huge database to say.


The benefits outweigh the costs because the cost is high.


Like many people do report tremendous improvement in things like brain fog, and energy. But I don’t have a huge phospholipids Yes, Omega six fats. Yes. I can vouch for those changing lives. Those margins, I’m still in the infancy of using them to see what clinical outcomes. Okay. I think they’re going to be a major player in the future. Hmm, very interesting. Very interesting. So what did they ask you? This is a personal question.


What does wellness mean to you, Dr. Hoffman?




it depends if you’re in the first month of life.


For the second half of life, we’ll say the second half if I think you might be in the second house.


Well, I happen to be


what’s glass half? Empty? Yeah.


All right. So we have a trajectory, the first half of life is taken up by drives, we have an innate capacity to become something with somebody, and we drawn towards some illusionary desire to fulfill our destiny on earth. And we have this sort of sense of immortality, if you will, because we don’t really think of N days, right. So we taken up. And so we sort of have a slight inflation, we have a slight increased sense of ourselves and our capabilities and possibilities. And all the hormones and the genes drive us to become and fulfill the drives to be seen by parents drives to be seen by the opposite sex drives, to educate, create financial security, and then pass on the genes. So in the first half of life wellness is to maximally fulfill those criteria, and keep your body as healthy as possible. But in the first half of life, it doesn’t matter what you do, you can be sort of, you can be a reprobate and still kind of get through quite well.


They can half of life, well, then then that’s when the rubber hits the road.


The drives are the first half of life, withdraw, hormones withdraw. And the ego drum is to become somebody that you’re not so driven, right? So that’s most soldier, who are you really? How much did you leave behind in your pursuit of the first half of life? what pieces do I have to go back and retrieve to fulfill who I’m really meant to be authentically myself? So then it’s not just the absence of disease, it’s really, am I living at my most maximum capacity as a human being fulfilling my destiny and fate for this one tiny life I’ve been given.


So there’s a gradation of disease management, sort of homeostasis, and then am I living that which are meant to live at my highest capacity. So I will think of it as stages of from disease to self actualization, there’s a whole spectrum of possibilities,


I guess of cynicism to throw it into.


You need a dash of humor as well write




in all halves of your life.


You can look back right when you’re in your 20s on 40. When you’re in your 20s or 30s, for me, at least. Oh my gosh, what was I thinking? And so I can imagine at your age, do you look back even at my age and think Oh,


no, I look like my son that loves to tell me I’ve only got 20 summers left, and what am I going to do with the remaining summon? And then the other day, I just went and got a big statue in my god and like to time statue, and I thought, Well, I’m gonna leave that for my son’s because I’m gonna be gone. He’s gonna have to move that off my property.


That’ll show you.


Oh, well, I really loved that. We talked a little bit about mast cell and a little bit about adrenal fatigue and mitochondria and hormones and phospho lipids rounded it off with classical lipids. So yeah, I love your perspective about the total body approach, you know, with the limbic system and the nervous system so and the soul, who are we rarely and what are we meant to fulfill? And who are we meant to become? Because you know, at birth, like acorn and the oak tree, the oak, the acorn knows it’s going to be an oak tree.


So in the pursuit of life and all the pleasures and pains you know, can we truly identify with who we meant to be? Do we know our soul from a young age? And can we fulfill and spread out into all the areas that it’s meant to become without without too much hubris and arrogance? Just can we live you know, an authentic life?


In the absence of disease, hopefully?


Do we know our soul?


Do we know who we are? Do we know so can we can we live with ourselves? Are we okay? You know,


that could be a whole a whole 40 interviews in itself. Do we know our soul?


I’m not that I lucked out with one of the great they’re one of the great traditions I caught


right into my work is the union card Young’s tradition of


union psychoanalysis, which is dream analysis, which the hypothesis is that our unconscious drives us towards fulfillment in the second half of life, while we fulfilled the conscious ego drives, does it, then through dreams and synchronicities? Can we fulfill the parts that we’ve forgotten? And that’s driven through the unconscious through dreams. And so I use lies and refer to Union analysis a lot for people who are struggling with sort of existential issues of Who are they and what they meant to be. So, integral part of the work that I did in fact, I only went to med school. In the end, once I realized why I was there was to become a union analyst that I never did. I did this. Oh my gosh, I love that part of your story.


That’s amazing. If people are interested in finding out about that, what’s it called Young called Young Carl Jung and Freud, Freud and Jung. Yeah. And Jung broke from Freud and set up his own thing and became psychotic and wrote the Red Book and yeah.


Okay, Carl. Yes, I’ve read. I’ve read one of his books before. So that’s amazing. I’m gonna pick that up again. So thanks for the little gentle reminder. It was his book memories, dreams and reflections, which made me want to do psychoanalysis. And I think my mom said, Oh, he wants to do psychoanalysis. Send him to med school to become a psychiatrist. So you can go do it. I think that was her reasoning.


And it wasn’t wrong.


It’s funny, I’ve learned maybe that was the unconscious mind at that point. Right.


Well, thank you so much, Dr. Hoffman for the time. I know you had a probably a long conference today, so I appreciate it. No, no, thank you. And thank you for putting the date the time later do


of course, of course. Alright, well, we will put all your information where people find can find you and all that good stuff. So I know you’re in it. So thanks. Okay. Bye for now. Thanks. Bye now. See you Bye

A Holistic Approach to Complex and Chronic Illness

Holistic Approach to Chronic Illness

In this podcast with Dr. Trevor Campbell, we discuss how an added comprehensive, holistic approach using social, psycho-spiritual, family dynamics and generational issues can be used to treat complex and chronic disease. Early childhood trauma of any kind as well as neglect can enormously impact the pathogenesis of disease as well as the course of recovery. This approach is foundational to my 7 Stages to Health and Transformation Model (TM), a fundamental approach to  integrative medicine. Please scroll down to listen to the podcast.

Learn More Here

Podcast: Looking at Lyme: Understanding Symptoms and Treating the Whole Person

Looking at Lyme

I was recently interviewed by Sarah Cormode for an episode of Looking at Lyme, an educational podcast created by the Canadian Lyme Disease Foundation, where I highlight the importance of taking an in-depth patient history to understand and document Lyme disease symptoms.

I also discuss several approaches to treating Lyme disease and explain why such a variety of symptoms amongst patients with Lyme disease exists.

Take a listen below.

I was recently interviewed by Sarah Cormode for an episode of Looking at Lyme, an educational podcast created by the Canadian Lyme Disease Foundation, where I highlight the importance of taking an in-depth patient history to understand and document symptoms.

I also discuss several approaches to treating Lyme disease and explain why such a variety of symptoms amongst patients with Lyme disease exists.

People with Lyme disease have a lot of different symptoms, the bacteria attacks the body in so many different ways. Sometimes it attacks the brain, the heart, the joints, you name it. Today I'm looking at Lyme, we're going to dive into functional medicine, we'll look at the body from a holistic perspective and meet a doctor who treats the whole body and the mind.

Getting treated early for acute Lyme disease is critical. Some people find the attach ticks and others might get a bull's eye rash. But that's not always the case. And without these telltale signs, people might not get diagnosed. The longer that you have the disease, the worse it gets, and the harder it is to treat. That's when we need to go to the doctor. So, let's do that. There are very few medical doctors with the expertise of Dr. Bruce Hoffman. He practices functional medicine, and we'll get him to tell us more about that. We reached him at his Calgary clinic. Good morning, Dr. Hoffman.

Good morning to you.

What's the first thing that you look for in a patient who potentially has Lyme disease?

Your patients present to a doctor's office with many symptoms and many complex, interlocking possible what we call in medicine, differential diagnosis. So, they present with a whole host of symptoms. And it's the task of the doctor taking the history to try and work out what may or may not be Lyme disease. And sometimes patients come in with some Lyme test and say they definitively have Lyme disease, or they have positive biomarkers for Lyme disease on some of the tests they've done. But when a closer history is taken, that may not be the case. So, there's quite a lot to really sift through when you're trying to differentiate whether somebody has Lyme disease or not. The most important thing is the symptomatology. You want to take a very definitive history. In my clinic, we use different types of questionnaires to try and determine whether or not Lyme may be a diagnosis. And we also then start to take a very specific history about whether they visited endemic areas, which is somewhat a moot point because Lyme disease is somewhat, you know, it's specific, it's everywhere. If they visit an endemic area, if they've been bitten by a tick, if they've had the rash, which is very uncommon, by the way. But we start to ask the history of exposure, history of tick bite, history of rashes and in a symptom history, looking over the variable symptoms that present with Lyme disease and/or co-infections that come along with Lyme disease. A lot of questions need to be asked, and you've got to sift through them and try and determine if Lyme disease is the primary presenting feature or are there any other coexisting disorders that interlock, like mold exposure, or heavy metal toxicity or food sensitivities? And there's many of them that may interlock with a symptom presentation. So, there's a lot to ask.

Yeah, it sounds like getting that patient history is just so critical. 

History is everything. You know, you've got to take a good history. You can’t have a patient walk in and say I've got Lyme disease, and I go, okay, let's treat you. No, no, you have to stop and really ask very specific questions.

And it also sounds like you mentioned that most of your patients don't ever remember having a tick attached or getting a rash.

You know, the majority don't. I do have a number of patients who went to college in northeast in the United States, and they were out in the fields and in the forests, have a history of tick bite and rash exposure. But I would say that's probably 5% of my population. My patient population, it's very low.

Guess when we spend time in the outdoors, if we check for ticks and do a tick check and actually found one attached, we have something to at least document or same with a rash. If you found one, it'd be a good idea to get a photo of that to share with your doctor.

Absolutely. It would be lovely if we had that cookie cutter you know, clear cut, walked in the woods, got a tick, notices for within three days a high fever, headache, and then the Lyme disease rash. That's so seldom.

It's never that that clear? Is it?

Never. I wish it was easier.

So how critical is it then for people to get diagnosed and treated early?

Oh, if they've been exposed and there's definitely a tick bite. And the symptomatology of high fever, sore neck, chills and joints. If that occurs, you get them on antibiotics while waiting for lab data or getting the tick, if it's discovered, sent off to the lab for analysis. Definitely, I’ll put them on treatment right away. And there's different standards of Lyme disease treatment, depending on which school of thought you belong to. Some schools of thought say, you just need like a brief dose of doxycycline. And others say at least four to six weeks of treatment. It depends on your approach.

Do you have a preference?

Longer term antibiotics, definitely not a short term

Yeah, that was certainly my experience, I had about 10 days of antibiotics, and then all of my symptoms came back afterwards.

Absolutely. If patients have an acute exposure, and they have symptomatology, we do have a baseline laboratory test. And then we repeat it four to eight weeks later to see if there's any rising titers. And we send the tick off for analysis. I usually cover them with antibiotics for at least six weeks. 

Wow. That's great to hear. And so, what is functional medicine?

Well, functional medicine is this emergent system of approaching a patient from a very different point of view. Like my medical training is what we, I don't mean to be derogatory, but it's called the N2D2 method of diagnosis and treatment; name the disease, name the drug. You know, that's how we learned in medical school, we just look at differential diagnoses, what disease or symptom cluster does this person have, and what drug can I pull out to help them. That's the specific training, highly relevant, nothing wrong with it. But now we have this emerging cohort of patients who have this chronic multi system, multi symptom disease profiles, with many interlocking issues. And that model doesn't work. And I tend to see and many people who are outside of the so-called traditional healthcare system tend to see that cohort of patients. Functional medicine attempts to take an upstream history back to what we call antecedents, mediators, and triggers. We go and look upstream to see, first of all, what's your symptom profile now? But, when did you start to feel unwell? One of the most relevant questions I ask a patient is; when did you last feel well, and then you want to take it from there, backwards and forwards. So functional medicine looks backwards as to the timeline, or the potential triggers and inherited factors which may play a role, the triggers what may have triggered the illness, and then what we call mediators, what may be keeping that symptom cluster alive. In conjunction with that we look at, not so much as pathology and disease laboratory tests, but we look at functional laboratory tests. How is the biochemistry and the metabolomics? How are they functioning? Are they optimized? Or are they deficient within a spectrum? Traditional Medicine has a reference range of, you know, negative or positive. Functional medicine optimizes function based on individual susceptibility and genetics. It's a very elegant form of practicing medicine within chemical principles. Just old school sort of, you know, when did you last feel well; what happened and what may have been playing a role. No longer looking at single factors, instead, looking at multiple causative factors as to what keeps this patient still symptomatic. And I can tell you, from my experience, that there is never one reason why a person is not feeling well. There's usually a whole myriad and host of issues from poor sleep, poor diet, early childhood trauma, dental issues, food and gut sensitivities. It is complex, long list of what made you unwell. 

Yeah, absolutely. Why do the symptoms vary so much from one patient to the other?

You mean with Lyme disease specifically?

Yes. with Lyme disease specifically?

Well, while it depends on a whole host of factors, it depends on the individual immune response of the person, the total toxic load, the infectious load, the expression of the Lyme disease spirochaete, with or without co infections, the metabolic and nutritional strength of the individual, the immune competencies, the presence of natural killer cell functions, whether they can suppress the immune response. The fact that Lyme disease goes from different forms; the cellular form to an intracellular form, to a cystic form to a biofilm form then it comes and goes depending on your immune surveillance. There's a lot of reasons why somebody has waxing and waning of symptoms and feels variations in their symptom profile.

Is it possible for someone to have Lyme but not have any symptoms?

You can have positive laboratory testing for Lyme and be asymptomatic. Absolutely, absolutely. But you don't see those people because they feel good.

Yeah, definitely. Do symptoms flare and go dormant normally for some of your patients?

They do. They wax and wane depending on stressors, diet, travel and multiple factors affect the expression of symptomatology. Treatment or no treatment. Some treatments exacerbate the symptomatology quite dramatically. They get what they call the Jarisch Herxheimer reaction (JHR) where you put in a treatment and the patient's symptoms just go through the roof. And so, there's all these variations as to why people wax and wane and get increased symptoms at times. But yeah, we certainly have people with, with no symptoms, who have positive laboratory tests as well.

Dr. Hoffman, are you seeing a larger increase in the number of patients that you suspect to have Lyme disease and other co infections?

Absolutely. Yeah. As you know that the Lyme disease diagnosis is highly controversial, depending on which school of thought you belong to. Whether you belong to the sort of infectious disease society, the infectious disease group of medicine, or whether you follow the ILADS criteria for the diagnosis and treatment. Those are these two different schools of thought. Now you know, even with that, there's been a tremendous uptake in the Lyme disease diagnosis and co-infections due to global warming. The migration of songbirds further north and the spread of ticks deeper into the north because of global warming. It's been estimated, one study showed that the songbird flight path from South America to North America brought up to 32 million tick species. In the yearly migration just northwards from South America. So, there's a there's a huge increase in the diagnosis. For sure.

Yeah, especially for anyone who's living along any kind of migratory bird path.

Absolutely. Yeah, absolutely. And there’s this great Canadian researcher, John Scott, showing us published papers on this issue.

Yes, hopefully, we'll get him on a future podcast as well. I'd love to hear more about his research

Absolutely. Yeah.

So I was fortunate to go to the ILADS conference last year in Boston, and I learned about mast cell activation. And I was just wondering if you could tell me a little bit about that disorder.

Well, Mast Cell Activation Syndrome (MCAS) is a relatively new diagnosis. It's been around for a while. Dr. Lawrence Afrin is one of the leaders in the diagnosis and treatment. He's just recently published, which I co-authored, a criteria for the diagnosis. And the reason why that has been important is because previously at medical school, we learned about systemic mastocytosis, which is an increase in the number of mast cells that create disease processes. But mast cell activation syndrome is an increase in activity without an increase in number. And there are different criteria for the diagnosis. Mast cell activation syndrome is a very, very important concept to keep in mind when seeing patients with chronic systemic illness because you'll see it a lot. I see it a lot. Mast cells or white cells act as vigilante cells to try and protect you from incoming stressors. Whatever they may be, whether it's mental, chemical, environmental, infections or food, they spew out at least 1000, not 200 as one's thought, but more than 1000 mediators of inflammation. One of them is histamines. Everybody knows the histamine is a sort of allergy hive reaction. There are many other mediators of inflammation. People with mast cell activation syndrome have this heightened inflammatory response to ongoing day to day environmental exposures and present with a multitude of symptoms in multiple organ systems. And they travel from doctor to doctor you know, they go to the allergist and the rheumatologist and to the neurologists, but nobody ties the systemic nature of this condition together. So, it's important again to take a thorough history and elicit whether somebody may be presenting with mast cell activation syndrome. Now, interestingly, mold exposures and Lyme disease trigger mast cell activation syndrome. So you often get a cross mapping of symptomatology.

Well, what would be your best advice for someone who suspects that they might have Lyme disease?

Well, it's a very tricky one. Because here's my experience. People often want to believe in a one diagnosis - one treatment approach when they present with complex illness. And it's really doesn't do them any favors to adopt that attitude. Yes, you may have a classic exposure and symptom profile, no question about that. But when you've got chronic illness, and chronic multi system, multi symptom exposures, and you go into a Lyme test with a naturopath or an MD, they send it to the states or even they send it to the Canadian Winnipeg group. And you come back with a positive test, it doesn't mean that the reason for your symptom profile is Lyme. Lyme may be the trigger, but you may have a whole host of underlying issues that are playing a role in your symptom profile. And one of the great tragedies that I see in my practice is people who come to see me, they've got a positive Lyme test and they've been treated for Lyme. But it's really not the key diagnosis, there are 70 other underlying factors that are far more relevant than that positive laboratory test. So, in response to your question is just be extremely discriminatory, when you jump to the diagnosis of Lyme disease as causing your symptoms, it may not be that. It may be there, you may have a positive test. But it doesn't mean that Lyme disease is at the root of it. It may be that it is. But you can't just take a positive test and treat it as if that's it. And I see that 90-95% of the time. They just go get treated for Lyme, but it's not really Lyme that's causing a symptom profile. Sometimes it is, of course it is, but you've got to discriminate.

So it's that combination of diagnostic testing and patient history,

History, history, history. If you're not taking a two-hour history with your patient, a timeline from conception to present, plus even intergenerational issues because we know that you inherit epigenetically family trauma. It is very well studied and well researched. Now, if you're not taking a thorough history, and following the timeline and symptom presentation of that patient, at least a two-hour history, you can't really discriminate on a history basis, whether this patient is suffering from one illness or 15 possible comorbid conditions. You have to take that history, then you back it up with laboratory data. The more laboratory data, the better, which unfortunately and again, with our healthcare system, that sort of privilege and that sort of luxury of a two-hour interview with extensive lab data. It doesn't exist. You have to go outside the healthcare system to get that service, you know, which is a tragedy, but it's the truth.

I couldn't agree more. Thank you so much for your time, Dr. Hoffman.

Thank you so much.

My key takeaway from that conversation was just how important it is that a doctor gets a full patient history. I know that in my case, I had a lot of symptoms and it was really confusing to understand what was going on in my body. That wraps up another podcast. Thank you so much for listening. Stay safe in the outdoors.

Podcast: Mast Cell Activation Syndrome With Dr Bruce Hoffman

I was recently interviewed for The Dr. Hedberg Show, where we spoke about mast cell activation syndrome and how exactly the condition is diagnosed. In this podcast, we reviewed the similarities that exist among certain conditions (fatigue, brain fog, and GERD to name a few) and how they may be indicative of mast cell activation syndrome.


Dr. Hedberg: Well, welcome everyone to “Functional Medicine Research.” I’m Dr. Hedberg. And I’m really looking forward to today’s conversation with Dr. Bruce Hoffman. He’s a board-certified physician, and he has a Fellowship in Anti-Aging Medicine, as well as a Master’s Degree in Clinical Nutrition. He’s a certified functional medicine practitioner. And, one of the really interesting things about him is that, in addition to his clinical training, he studied with many of the leading mind-body and spiritual healers of our time. People like Deepak Chopra, Paul Lowe, Osho, Ramesh Balsekar, and one of my favorites, Jon Kabat-Zinn.

So, Dr. Hoffman, you shared the stage with Dr. Deepak Chopra and Dr. John Demartini. And he continues to spread his inspiring vision of healing and wellness with audiences and patients around the world. So, Dr. Hoffman, welcome to the show.

Dr. Hoffman: Thanks very much, Nikolas. I’m glad to be here. Thank you.

Dr. Hedberg: Great. So I’m really looking forward to this discussion on mast cell activation syndrome. It’s something I haven’t seen a lot of in my practice. I have heard a number of lectures on this and read quite a bit about it. And it seems to be an area of your expertise. So why don’t we jump right in and just talk about what mast cell activation is, and how is this condition diagnosed?

Dr. Hoffman: Sure. I first got interested in mast cell activation syndrome when I started to work with a cancer patient advocate by the name of Dr. Mark Renneker out of San Francisco. And he alerted me to the connection between cancer and mast cell activation syndrome, particularly in gynecological cancers. And then put me in touch with Dr. Lawrence Afrin, who leads one of the major sort of advocacy groups for mast cell activation syndrome as opposed to systemic mastocytosis, which I’ll explain in a bit.

And so, I’ve been for the last three to four years working with Dr. Lawrence Afrin’s group and learning to understand the implications of mast cell activation syndrome in most of the patients that we see. Which are chronic multisystem, multisymptom patients who, as you know, have been everywhere and remain frustrated with the one disease, one drug paradigm that we learned at medical school. So, what I learned over time was how to separate between two specific conditions, one called systemic mastocytosis and the other called mast cell activation syndrome.

Mast CellBut before I begin with that, I’d like to say that mast cells are part of, they’re produced in our bone marrow, and they’re part of our immune system. And they make up a very small percentage of it. And they act as defense structures against incoming invading pathogens. So, anything that comes into our environment or into our biome, mast cells are often at the first line of defense. And they were actually discovered a long time ago, 1878, I believe, by Paul Ehrlich. And he called them mast cells because they were fat and puffy.

And the word mast in Greek means breast or the German means masticate. So, this is how the name mast cell got generated. Just for your North American readers, I say mast, and most people don’t know what I’m saying. So, it is mast in North America. People often don’t know mast cells, what I’m saying.

So, these were originally discovered by Paul Ehrlich when he developed specific staining for them. And since then, they sort of lingered on in the literature. They were linked early on to cancer, but that sort of faded out of the picture until it was resuscitated by some Italian researchers who now are doing massive amounts of work on mast cell activation syndrome and cancers. And then it really sort of resurfaced in the 1990s and didn’t really gather steam until about 2007, when two, you know, researchers and clinicians put together sort of a consensus statement on what constitutes MCAS.

There are two different schools of thought and they do tend to conflict with each other in terms of the diagnostic criteria. But basically, mast cells being part of the immune system, and regulating many of the incoming so-called antigens or toxins tend to be distributed in almost all tissues, but nowhere quite as much as on mucosal surfaces: so eyes, mouth, skin, GI tract, bladder, etc. They’re also found in other tissues, you know, lungs and heart tissues, and brain, many mast cells are activated in the brain.

And so, when they get triggered, they do tend to release many, many mediators of inflammation. And it was estimated that there were over 200 mediators of inflammation that get released by these mast cells. But Dr. Afrin in a very recent post, as of last night, said that he’s now changing his opinion that he believes there are over 1,000 mediators released by mast cells. All these inflammatory mediators like histamine, like proteases, prostaglandins, leukotrienes, all these inflammatory mediators that then set up this multisystem, inflammatory response, which can confuse diagnosticians particularly if you have been trained in single organ, you know, specialties.

So that leads to the sort of difficulty with the diagnosis as people present with many different symptoms. And unless you have an understanding of mast cell activation syndrome, and a method of sort of sifting through the multiple systems they can present, you can often get very confused and misled. So, the recent, you know, people speaking about mast cell activation syndrome is an attempt to bring some coherence to this somewhat disorganized field. And hence, establishing criteria for the diagnosis, lab tests, and then treatment protocols. So now it’s coming into its own and I think you’re going to hear a lot about it in the years to come.

Dr. Hedberg: Mm-hmm, so we’re talking about illnesses that may be so-called mystery illnesses, and multifactorial presentations like gut issues, skin, brain, and things like that. Can you just let everyone know some of the overlap that you see in various conditions in your practice that would specifically indicate mast cell activation syndrome?

Dr. Hoffman: Yeah. So, mast cells, when they release the inflammatory mediators, can present locally or systemically. So, a local condition would be something like hives, urticaria, or interstitial cystitis. Or it can be systemically like people can present with cognitive symptoms. So, they’ll have fatigue and brain fog, and associated GI symptoms, like GERD. GERD is a potentially very big diagnostic category for mast cell activation syndrome or, you know, the irritable bowel syndrome. Even the autoimmune diseases of Crohn’s disease and ulcerative colitis have been linked to mast cell activation syndrome.

Asthma is another one. Asthma, you know, if you analyze all the triggers of an asthma response, and you identify them, like, for instance, mold, allergy or mold inflammation, which are two different criteria, and you remove the trigger and downregulate the mast cell activation potential, I can’t tell you how many cases of asthma have been absolutely shut down when you treat the mast cell activation. It’s very rewarding. The same goes for GERD, the same goes for irritable bowel syndrome. The same goes for anxiety and cognitive decline. When you target the triggers and downregulate the mast cell activation, it’s very rewarding to treat these patients, and they’re very grateful. Angioedema, another one, canker sores another one, there’s many, many symptoms in all the organs that can present with this syndrome.

Afrin has written a chapter in a book. The book is called “Mast Cells,” the editor is David Murray. The chapter is chapter…I think it’s chapter 6, and it’s called Presentation, Diagnosis and Management of Mast Cell Activation Syndrome. And at the back, he gives a long, long list of every organ that can be affected from ophthalmic, to lymphatic, to pulmonary, to cardiovascular, and just goes through all the systems. Even fibromyalgia, even osteoporosis, headache, all the mood disorders, dysmenorrhea, endometriosis, many of the hematological conditions, the immunological conditions. There’s a huge long list of different organ systems that can be affected that present as isolated diagnoses to specialists, but often they miss the overriding pathophysiological basis to the condition.

And our training as MDs makes us very aware of what is called systemic mastocytosis, which is when the mast cell from a clonal perspective within the bone marrow becomes amplified. There’s actually a mutation of the KIT gene. And the mast cells become very high in numbers. So, there’s increased numbers of mast cells, which is systemic mastocytosis, which is very different from mast cell activation syndrome, which is an abnormal reaction of the mast cells, not an increased number.

So, I can’t tell you how many patients come back to me after having got the diagnosis of mast cell activation syndrome by myself with the criteria I use, go to the specialties, go to the hematologist, go to the gastroenterologist, or pulmonologist, who then does a serum tryptase and even sometimes go as far as do a bone marrow biopsy, and then come back and say, “Oh, that diagnosis is incorrect, he doesn’t or she doesn’t have systemic mastocytosis.” Systemic mastocytosis is a very rare condition, I’ve never seen one in my life. But I see almost twice a day, mast cell activation syndrome. Dr. Afrin believes that probably about 30% of the population gets affected to some degree or the other.

Dr. Hedberg: And are there any theories at this point about why mast cells become so overactive in an individual’s body. Any good research out there on that?

Dr. Hoffman: Well, there’s lots of speculation. And the most common hypothesis is that we do live in a much more sort of, you know…we’re inundated, so to speak, with multiple stressors far more than our capacity to withstand them. Our immune system, it just gets triggered because of multiple stressors. And there are many triggers for mast cell activation. Poor sleep. Stress is one of the biggest triggers. Food, I mean, food is incredible in its ability to trigger the mast cells that are in the mucosal surfaces of the mouth through to the anus.

So, we believe that our ability to…..we can no longer withstand the onslaught of our ongoing multiple stressors, whether they be environmental, emotional, nutritional. We just are in this constant state of over reactivity if you’re genetically predisposed. Now, Dr. Afrin doesn’t believe it’s necessarily a genetic condition that is transmitted through the germline. But he believes there are mutations in some of the mast cell production. And Dr. Molderings, who’s published a lot of papers with Dr. Afrin, has done a lot of research on the so-called KIT mutation, not in the bone marrow, but within the mast cells themselves, and has shown that they are these sporadic and spontaneous mutations that occur. Why those occur? I can’t say. I don’t know the answer to that. Yeah.


Lab Tests

Dr. Hedberg: So, there’s a number of functional medicine practitioners listening to this, so let’s just talk a little bit about lab tests, and some of the ones that you’re using and the ones that are beneficial. Obviously, CBC might be beneficial with elevated eosinophils, basophil, or possibly those are normal, histamine testing and things like that. What are some of the top tests you’re doing in your practice to identify this?

Dr. Hoffman: So yes, we do all the normal standard CBC and electrolytes, and liver function, etc., but those don’t usually yield what you’re looking for. And one of the challenges is that the lab testing positive results fluctuate depending on whether the symptoms are being expressed or not.

So, the first thing is you want to try and catch a person in a flare. Well, that’s difficult you know. So that’s the first challenge. And many of these tests need to be repeated over and over again until you get what Dr. Afrin likes to identify as two positive lab tests, which I’ll explain in a second. The second challenge is that you have to process a lot of these labs on ice. You have to have a refrigerated centrifuge to get accurate results. And it took me two years to get a refrigerated centrifuge. And as soon as I was able to, the positive rate of my lab has skyrocketed. Many of these lab specimens are very poorly handled. And, you know, they sit around for days and you’ll get these false positives for sure, false negatives, I mean. Sorry.

And also, a lot of the mast cell activation syndrome people or patients, they don’t always cause these abnormalities in the lab tests. Positive lab work is only obtained around 20% of the time. So, it’s quite frustrating, you know. But if you want to get lab work tests, I use sort of the minor and the major criteria. There are 10 major lab tests that we do. And then depending on the budget, we do the top 5 or 10, if we can.

And the tests that I recommend are plasma histamine, has to be chilled. And you should catch a person who’s in a flare. If they’re not in a flare, it will very often be negative. And you’ve also got to stop some of the inhibitors of histamine for five days prior to the test. Otherwise, you will get suppression of the histamine response. If people are on, you know, H1 or H2 blockers, you won’t get a positive test. And many people do take them intermittently you know.

Then we look for N-methylhistamine, which is a 24-hour urine also needs to be chilled. And then probably the one test that I get the most positives out of is the prostaglandin D2 plasma test, also must be chilled. And for that test, patients need to be off of all nonsteroidal anti-inflammatories, Motrin, Advil, or aspirin, or salicylate-containing foods. They can’t have a high salicylate diet. Anything containing aspirin for up to five days.

And then the one that is also done is the prostaglandin D2, 24-hour urine, also must be chilled with the same criteria of having to be off of all these medications. And then the last one is chromogranin A, and for that test you have to be off proton pump inhibitors and H2 blockers like famotidine. So, if you do go on proton pump inhibitors and so forth, they can falsely elevate chromogranin A.

And then after that, we’ve got prostaglandins 11 beta F2 alpha, a 24-hour urine, also must be chilled. And then the one that most MDs know about, which is serum tryptase. But this is rarely elevated in mast cell activation syndrome. It’s very important that every doctor who wishes to sort of work with mast cell patients knows this to be true. Because if the tryptase comes back normal, very often, the entire sort of clinical diagnostic differential gets thrown out, “Oh, they don’t have mast cell activation syndrome.” Big mistake, big, big, big mistake.

One of the criteria, one of the two different schools of the consensus criteria, they say that you have to have the serum tryptase elevated over 20% of baseline, or have a baseline greater than 15 nanograms per mil. But Dr. Afrin, who’s somewhat opposed to the consensus statement put out by Aiken and others, he highly disputes this finding and he doesn’t agree entirely that this is one of the main criteria to make the diagnosis. And I tend to agree with him.

Leukotriene E4, a 24-hour urine. Plasma heparin because heparin gets secreted by mast cells. And then a blood clotting profile, thrombin, PTT and INR is often done. And those are the top 10 and then after that, there’s many others; anti-IgE receptor antibodies, pheochromocytoma workup. We often do factor VIII deficiency workup, we do urinary metanephrines often. We almost always get an immunoglobulin profile IgG, IgA, IgE, and IgM. You might see IgE elevated or not. Often you won’t have an elevated IgE. So many people think “Oh, if a high IgE, then it can’t be this.” But that’s not true you can get a non-IgE-mediated mast cell activation. People then do bone marrow biopsies. People can do gastrin, serum gastrin levels. And then as you mentioned, the CBC with eosinophils and basophils can sometimes are elevated. Antiphospholipid antibodies are also often done.

And one test I like to do in the functional world is the Dunwoody Lab test for zonulin, histamine, and the DAO enzyme activity because that’s the diamine oxidase enzyme that sits on the villi that can be genetically compromised. Or because the villi are compromised, you cannot produce enough diamine oxidase. And that’s when you start to put people on low histamine diets and use the HistDAO enzyme to help break down any remaining histamine in food.

But I can tell you the one test that I tend to rely on more than any other right now, apart from the serum and urine test, is to get restaining of any gastric biopsies people have done. This has been overwhelmingly sort of helpful to some of my chronic GI tract patients in particular. So they would have gone, you know, to a GI specialist, they would have had the normal Giemsa tissue stain, and they comment on lymphocytosis. But they don’t actually comment on mast cell activation. And unless they get what’s called the CD117 stain, you won’t isolate the mast cells.

And almost 90% of people that I’ve clinically suspected of having mast cell activation syndrome turn up once they have their biopsies restained of having over 20 cells per high-power field being positive for mast cells. Which is the cut-off criteria that’s been agreed upon by numerous researchers, highly contested, by the way, by some pathologists and gastroenterologists. But we use a cut-off point of greater than 20 mast cells per high-power field to make a diagnosis of mast cell activation syndrome, particularly in the GI tract. The mast cells are very rich in the GI tract, particularly in the duodenum, not so much in the gastric tissue, but particularly in the duodenum.

So, if they ever had a biopsy in the duodenum, phone up the pathologist or write a letter and say, “Please will you restain for the CD117 stain.” And as I said, probably 9 out of 10 come back positive, very helpful. And then the patient sees that and the penny drops then they start reading up all the literature. And then they get on board for the treatment protocols which are, you know, quite…it can be onerous, and they can be extensive. But they’re very clearly delineated with multiple challenges along the way. Because people react to the medications and/or the supplements that you give them because that’s the nature of the condition.



So, they’ll come back and say, “I can’t take the H1 blocker because I got worse.” Well, most of the time, it’s because it’s the excipient, the additive, the filler, or dye inside the medication that triggered the mast cell syndrome and it’s not the actual problem. You know, they’re not reactive to the supplement, they’re reactive to the excipient within the supplement or the drug. So those are some thoughts.


Doctors in meeting

Dr. Hedberg: Right. So once you’ve identified that someone has this syndrome, let’s talk about some of the natural treatments. You just mentioned that some of them are very difficult to follow. And some of these patients are…there’s probably a fair amount of trial and error with some of these patients figuring out what works for them. So, can you just talk a little bit about some of the treatments you’re using?

Dr. Hoffman: Sure. One of the hallmarks of this condition and one of the setups in my interaction with patients is a description of the complexity of the diagnosis and the challenges. And if you don’t have that conversation, you’ll often get a frustrated patient because they’ll come back with flare-ups and they understand it. So, I encourage that all your practitioners who wish to dive into this field really wont understand how patients can flare and how they

may have multiple triggers at any given time. And that the treatment may need to change, and that they mustn’t become frustrated, they must just stay for the long course. And they are sort of part of the team of trying to work out these multiple moving targets.

So the education is number one. I have two handouts, where I’ve described mast cell activation syndrome and mast cell activation syndrome treatment. I make sure they’ve read that. If they’re more interested, I give them Dr. Afrin’s book, “Never Bet Against Occam.” There are many patients who love to read because it’s filled with case histories. So once they get sort of an insight into other cases of complex presentation, they get encouraged to push on. So, education is first.

Second is to try and identify the triggers that trigger their mast cell activation. And this is one of the greatest challenges because there are many triggers from, you know, hot, too much heat, too much cold, stress, poor sleep, as mentioned. And then we get into the more obvious triggers, chemicals, heavy metals, dietary antigens, and then infections or inflammatory triggers like mold.

So, part of the process of working up mast cell patient is not just diagnosing the syndrome, but also trying to work up the triggers. So, in most patients, I do multiple food sensitivity profiles. I don’t just do IgG. I do IgG, IgG4, I do the so-called LEAP test. I do…am I allowed to mentioned lab names on your podcast?

Dr. Hedberg: Yes, definitely.

Dr. Hoffman: Okay. I do the lymphocyte sensitivity tests, the LEAP test. I do, as I said, IgE testing, IgG, IgG4. And I do Cyrex Lab food, I do the 10x, I think it is, with all three panels looking for dietary antigens. So, the Cyrex panel is different from the Meridian Valley food panel. Meridian Valley says it’s an IgG, IgE panel, but I disputed that once, and I’m not too sure there’s much IgE in the Meridian Valley panel. I think it’s more IgG. Whereas the Cyrex panel is more IgG and IgA. And you’ll often get contradictory findings. They’re very frustrating. That’s part of why allergists like to just throw them out, they say, “Don’t bring me this nonsense.”

But once you’ve been doing functional medicine for a long time and you have an understanding of the different complexities of dietary triggers, you can look at these profiles and you can sort of pull out the relevant data. And I encourage those of you who may be new practitioners is not to take each test literally. So, if they have a high say a banana on the one test and it’s not on the other, you want to look at the general profile of the dietary antigen testing. You don’t want to be too specific because if you get too specific, most people will have nothing left to eat. So, I’d look at the dietary antigens and most of the time, but not all the time, controversially or not, I tend to put people on the Paleo, autoimmune, low histamine diet for the first month or two. And I can’t tell you how many people immediately settle down just on that one intervention.

And I take out the high histaminic foods, and that is a very important part of it. And one of the great crazes right now is to use all these fermented foods to heal gut permeability, but it’s a disaster for the mast cell person. So, I’m always pulling people off sauerkraut, and kombuchas, and bone broth, it’s a huge trigger. So, all the fermented foods, and then all the leftover foods. As foods break down, then the proteins, the histamine gets broken down by bacteria that releases histamine. So, leftovers are no, no. We also ask people to, once they’ve cooked a meal, to put in the freezer and then to take it out and unfreeze it, but not to leave it sitting in the fridge for days.

And then things like tuna fish, huge triggers, the nightshades (tomato, potato, eggplant, peppers), huge triggers in many people. And even amongst, you know, some of the vegetable kingdom, you know, peas and beans can be triggers of mast cell activation. And so, you have to be careful when you look at the testing, you’re going to sort of see… when I look at particularly the Meridian Valley test, you can often see a mast cell patient, they’ll show up, all the legumes will be positive, all the histaminic fruits will be positive. Candida will often be positive.

And there’s like a trend you can see it and then immediately, you know this is a mast cell activation profile for food antigens. So, we remove the foods, we always treat gut dysbiosis as you know. I use two different labs for gut analysis. I use the Genova GI Effects, and I use the Diagnostic Laboratory Solution’s GI-MAPs. They contradict each other all the time, you know, one will have a zonulin of 700, the other one has zonulin as normal.

But then you just got to use your clinical acumen and your experience and correlate the labs against the symptom profile of the patient and do the best thing. I do tend to use Dunwoody Labs for the zonulin, the DAO, and histamine, as I mentioned. And then the second page of that test is all the LPS, the lipopolysaccharides, to see if there’s been any endotoxemia. And if there’s been any bacterial endotoxemia, you start entering into a whole new world of immune upregulation, which, you know, you have to down regulate in your treatment protocols and heal the leaky gut, etc. which I’m sure your listeners are very well aware of.


Stethescope sitting on open book

So A. is education, B. is testing, C. is removing the histaminic foods and downregulating inflammation in general. And then we get to specific treatments. And I differentiate between pharmaceuticals and botanicals. I tend to preferentially go to the pharmaceuticals to start with because they work quickly, if they’re going to work. And I tend to secondly, add botanicals. But I tend to be an MD, you know, it’s just my preference. I’m sure many naturopaths would go the other way. And many patients refuse to do pharmaceuticals and then I just have to use botanicals.

Pharmaceutical perspective, they must be compounded, you can’t get over-the-counter. Although paradoxically, some people do better on the over-the-counter than they do on the compounded. This is one of the challenges is what you think is going to work doesn’t work. This is why try, try, and try again, you know.

So, first thing, H1 blockers. Histamine 1 blockers, and I tend to use levocetirizine in a dose of 5 milligrams going up to 7.5, even 10 milligrams. And I think the trick to using H1 blockers is you have to dose it round the clock. You know on the box it will say “24-hour relief” that’s not true. You need to dose it at least 12 hourly and sometimes 8 hourly to create full round the clock mast cell blockade. And you’ve got your H1 blockers, you’ve got your first-generation and your second-generation. The first-generation H1 blockers like Benadryl, or ketotifen, cross the blood-brain barrier and have a sedating effect so those are often given at night.

I love to use ketotifen, I use lots of it on a dose ranging from 0.25mg, which is a homeopathic dose almost, right up 2 to 3 milligrams at night. And if there’s any issues with insomnia, it works like a dream. It’s absolutely spectacular for sedation. The problem is sometimes they over sedate when you have to lower the dose. But it also downregulates mast cell activity at night. So first-generation H1 blockers, I prefer ketotifen over Benadryl. Second-generation H1 blockers, I use levocetirizine as my preferred go-to H1 blocker.

And then I use H2 blockers, and I use famotidine in a dose of 20 milligrams twice a day, sometimes going up to three times a day. And this tends to downregulate all the mast cell activation activity in the GI tract.

One of the little tricks of the trade I’ve picked up over time is if you do the Genova GI Effects, you’ll often see that eosinophil protein X marker a little high, that’s almost a slam dunk for mast cell activation…not always because there’s other things that trigger that. But if you see that with a constellation of other positives, you follow that marker closely because when that starts to downregulate, you know, you’ve got your mast cell activity under control. So those are my first two go-to medications H1 and H2 blockers.

Probably my next is cromolyn. Cromolyn is a mast cell stabilizer particularly for people who are very food sensitive. You take it before meals. I give it along with the HistDAO enzyme. And that dose you can take it from 100 to 300 milligrams, and that can also be a major game-changer in many people’s lives. You have to play with the dose, you have to play with the different companies that make it. It’s a bit of a tricky thing, but it can really have a huge effect on downregulation of mast cell activation.

And then the fourth drug that I use, and many patients have come back to me with this fourth drug, Singulair, montelukast. This downregulates leukotrienes, which are one of the thousand mediators of inflammation. One of the things that we’ve noticed in mast cell syndrome is that when you think a patient has an upregulated leukotriene pathway, which is typical for asthma, you give the montelukast or the Singulair and the asthma is managed.

Well, it so happens that one can’t predict which class of drugs is going to work on which mediator. So, if you give a mast cell stabilizer for food sensitivities, guess what? The asthma may go away. Or if you give Singulair for asthma symptoms, the hives go away. So, thereis crosstalk amongst many of the mediators. And it’s a great mystery as to why that occurs, nobody’s worked it out yet. Dr. Afrin said he doesn’t know. He doesn’t know why this happens and he’s going to keep researching till he works it out. So those are the four drugs I use, probably the top four drugs I use over and over again.



Nutraceuticals, of course, Quercetin, tops the list, no question about it. There’s a product called Natural D-Hist made by Ortho Molecular, that’s my go-to supplement over and over again. Two, three times a day seems to be the magic dose. And then using HistDAO one to two before each meal that seems to be the number one nutraceutical.

Number two would be vitamin C, either orally or intravenously, sometimes can have a huge benefit as well. Green tea has an effect. Turmeric or curcumin can have an effect but some people react to it. If you see on the food sensitivity profile, if you see that it’s positive in at least one or two tests, you can use it, but you want to be cautious because it can sometimes activate mast cell activation. You got to be careful with turmeric. Resveratrol is another one. And chamomile tea has some calming effects. So those are my sort of…they’re called the A team of my nutraceutical approach.

And the B team is sort of…there are many others like luteolin, Ginkgo biloba, Pycnogenol. Pycnogenol is a great one too I use quite a lot of Pycnogenol. Feverfew works. There are many things that can work. So, I pick and choose and go through them and change them. I ask everybody to first identify the triggers, if they can, and then to start rotating the pharmaceuticals and/or nutraceuticals and see which has the biggest blockade effect. And people soon work it out, you know. You’ve got to get a good compounding pharmacist on your side. And you got to make sure that they don’t fill the compounded pharmaceuticals with lots of fillers and dyes because some people react to that.

And then one of the other challenges…I just had a very seriously ill patient present to a hospital with anaphylaxis and she was on polypharmacy. She was on 10 different drugs. And many of the drugs she was on were triggers for her mast cell activation. And those were never identified as triggers by her medical team. And so, we asked the pharmacist to go through each drug and look for the additives. Many of them had iodine in them, many of them, there was soy extract base, and those had to be changed accordingly. And she settled down. So those are some of the challenges I have.

Dr. Hedberg: And one of the drugs that wasn’t mentioned was LDN, low-dose naltrexone, I know some practitioners are using that for this. Have you tried that or used it?

Dr. Hoffman: I do use low-dose naltrexone. It’s part of the many other…there’s many other alpha-lipoic, and so forth. And LDN is definitely part of it. And LDN has an effect particularly on autoimmune responses and downregulation of an inflammatory response. It’s not my first drug though, I don’t go to LDN as my first line. I use it if there’s autoimmunity and lots of gut permeability then I bring in LDN. And LDN is challenging because people give it at night but it can be very activating. Just yesterday, I saw a patient who since she started LDN hasn’t slept a wink. We changed it to morning.

Dr. Hedberg: Right. So how do you deal with the psychoneuroimmunology aspects of this condition? You know, some people, they develop a deep identification with their illness, and then they develop a lot of beliefs about things that they’re sensitive to. And we’re not saying that it’s all in their head, but we do know from the PNI research that what we believe, and what we emphasize, and think about, and focus on can affect the immune system and our biochemistry. So, are you using any kind of cognitive behavioral therapy or things like that, that could help some of these patients who are so focused on their condition and their hypersensitivities?

Dr. Hoffman: Yeah, because this opens up a huge area of the work that I’ve been forced to look at over time and for which I use quite a complex algorithm to sort of diagnose and treat. I’ve studied Ayurveda for years and I use the Ayurvedic model of layers and levels of healing. And when a person presents with specific belief systems around their condition, I have to sort of look through the layers and levels of what may be playing a role in that belief system.

Just very briefly, I tend to look at these diagnostic criteria. I look at the family system to see what family system they were born into and what beliefs the family system carried. Because I can’t tell you how many cases get resolved when we do what’s called family constellation therapy and look at the entanglements of the forefathers and ancestors, and how those epigenetically got transferred down to the offspring. Very profound piece of work, I cannot emphasize it enough. And I encourage all functional medicine practitioners to get a very sound footing on the epigenetic transfer of family system trauma and the entanglements that can be inherited, completely silently, unknown consciously to the patient, only uncovered through work in family constellation therapy whereby certain methodology is employed to determine what these factors may be. So that’s number one.

Number two, I look at early developmental trauma patterns, and ego strength, and defense systems of a patient. And I employ a number of ways to identify that. The number one system that I look at is looking at defense structures of the patient and the ego strength. And you can tell after, you know, half an hour, is this person…do they have good ego strength? Are they resilient or they do have a fragile ego structure? And I send people for quite a lot of psychometric testing to establish some of these criteria.

I have a psychologist I work with who is able to help me with some of the psychometrics. And we even do, you know, some of the simple psychometrics testing, and even the Burns Inventory, the ACE Questionnaire. When we do qEEGs, we do the in-depth psychological assessment that’s provided by the CNS Vital Signs software to look at which of their psychological profiles are most dominant. Is it anxiety, OCD, is it depression, etc.?

So we look at that level of their development, the ego strength and their defenses. And then we look at early developmental trauma. And as you know from literature, people who have early developmental trauma have very different brain structures. They have, you know, very often this hugely enlarged anterior cingulate gyrus. They have in their beta, their fast brainwaves, there’s two to three standard deviations above normal. Their capacity to inhibit the sort of reptilian, limbic brain is diminished. And those are challenging patients, very challenging, and you have to address that level of healing.

This is not a biological intervention. There’s not much you can do biologically unless you identify what the core ego strength resilience of the patient is. How much projection of will the patient has? Many patients will sit in front of you, project the will to heal on you. And that’s a slippery slope. If they are not invested in sort of figuring it out on their own with you, you have a problem on your hands, you know. And patients will often project their early developmental trauma of parents on to you, whether it’s positive or negative. Best to have a positive projection in the beginning. But if you are the evil father that you get projected onto you, you’re in trouble.

So it behooves all of us as functional medicine practitioners to kind of try and identify, who is this person sitting in front of me, what did they inherit, how was the early developmental life? And then what defenses are they employing to keep away feelings they don’t want to feel? And I use a psychological technique called ISTDP. And I refer that out to somebody who’s specialized in it. That person I use is also very well versed in CBT. But CBT, without the underpinnings of the complexity of the presentation, can sometimes not stick. It can be very helpful to some, but for those who are fragile with projection of will, CBT will not hold. You can’t use CBT, it washes off them, you know, they won’t be able to hold that.

The next thing I do, I do NeuroQuant MRIs on everybody as well as a qEEG. And I look at the brain patterns and I can’t tell you how helpful that is. If you’ve got this high beta brainwave, and you’ve got maybe high theta brainwaves with not enough alpha, you’ve got work to do. And then you correlate that with the NeuroQuant MRI, and we look particularly for the amygdala upregulation. Many of these people with anxiety, OCD, and belief systems around the illness, who are multiple chemically sensitive and environmentally sensitive and are triggered by everything, will have a very…..the amygdala will be 2 standard deviations above normal, being like in the 97th percentile. The thalamus will be in the 97th percentile.

Hand holding image of brain

And the thalamus is rich in mast cells. So, when the thalamus is high, the amygdala is high, you want to ask about mast cell activation, and you want to ask about early developmental trauma. Because the amygdala gets increased in size when there’s repeated stresses on the fear-based part of the limbic brain. And if I see that, I often start inquiring about other techniques to downregulate the amygdala. And that we use DNRS, as you’re probably aware of the Dynamic Neural Retraining System.

We do refer people to that, we do neurofeedback, we do biofeedback, we do vagal tone stimulation. And we start to bring in the Porges polyvagal theory of, you know, sympathetic, parasympathetic dorsal vagal shutdown. And we try to work out where in this constellation of symptoms is this patient presenting? Are they in dorsal vagal shutdown with a rigid defense and sort of no will to get better? Are they getting secondary gain? That’s a very different patient from the one who’s, you know, loved by the parents, no developmental trauma, is loved and seen by a mother, develop appropriate right prefrontal cortex to self-regulate, has financial resources, is loved by the husband, the kids are doing well, they have a home to go to. This is how it works.

And we have to work out who are we sitting in front of when it comes to addressing some of these complex beliefs about, you know, is this a biological overreactive reactive mast cell syndrome, or is this a psychologically overreactive amygdala? Or is this person highly defended? Do they have the ego structure to take on what I’m about to tell them? It’s complex, as you know. I think that…

Dr. Hedberg: Right. And it’s a difficult situation for everyone because, you know, we don’t really get a lot of training, if at all, in all these things you just mentioned. So, we have to learn these things on our own, learn how to incorporate them. And then at the same time, present these to the patient in a way that isn’t telling them that you know, “This is just all in your head” or helping them understand that some of this could be due to your childhood and the way that your parents treated you, and all these kinds of things that happen. And I have done a few podcasts with some experts on adverse childhood experiences and things like that.

So, it’s refreshing to hear you talk about all these things, and it just creates a very complex picture on how to put it all together. And you know, like you said, they come to see you and they put all the burden on you for the healing. And then, you know, you come back with recommendations that, “Well, we need to work on your childhood trauma or your relationships,” and things like that. So, this is a very difficult, you know, condition to take on as a practitioner. I mean its massive amount of mental and emotional output that you have to take on.

Dr. Hoffman: Yes, one of the commonest words I see in the referrals back from specialists is this so-called, awful term, somatization disorder. And it’s just not true 90% of one of the most stressful diagnoses for one of these patients to get is the so-called somatization disorder but it’s often handed out. You know, and, “Yeah, it’s all in your head,” this is so awful. There may be a component that is filtered through the neurological pathways and then synapses. And they may tend to have an upregulated sensory system that processes things somatically. But it doesn’t mean to say that we have to discard this as all psychological, which is very often the insurance companies like to do things like that and some of the specialties too.

I recently referred a patient to a psychiatrist for insurance purposes and I sent five articles plus a written response. “Please do not diagnose this patient as being psychiatric, he has the following conditions.” And then we listed the mast cell activation, the mold sensitivities, electromagnetic sensitivities, etc. And I sent him five papers in support of the validity of this diagnosis. I haven’t heard back yet; I’m waiting to see what the response is. We often have to advocate for our patients in this way because they do present with neuropsychiatric manifestations, but it’s as a consequence, it’s not the cause. Although there may be some issues which provoked, you know, an expression of a mast cell disorder, but you can’t separate you know, mind-body, you’ve got to work with the whole continuum.

Dr. Hedberg: Exactly. Well, this has been really excellent. How would you like people to find you online, what’s your website and contact information?

Dr. Hoffman: The website is hoffmancentre.com. And the phone number here is 403-206-2333. That’s the phone number for my clinic. I do have a number of blogs on my website, and I post to Facebook and Instagram. But my website has a lot of the histaminic articles as blogs, so they can access them on there.

Dr. Hedberg: Excellent. So, to all the listeners, I have created a transcript of this conversation, which will be on drhedberg.com. So just search for Dr. Hoffman and you’ll be able to get the entire transcript there in case you missed anything. Well, thanks for tuning in, everyone. Talk to you next time. This is Dr. Hedberg, and take care.

Wireless Tech, Electricity & Your Health | Hosted by The Hoffman Centre


You cannot see, taste, hear, or touch them but the human-made emissions from wireless tech and electricity are everywhere and our exposure to them has been increasing exponentially for many years. In practical and easy to understand language this talk will explore the different types of human-made electromagnetic fields from wireless tech and electricity, the potential health effects and what you can do to reduce your exposure.

WHEN: June 14, 2019
1:00pm - 5:00pm
The Hoffman Centre for Integrative & Functional Medicine
$150 per person

During this private event at The Hoffman Centre, you'll learn:

  • How to unpack the messy science behind biological effects from wireless tech and electricity exposures.
  • Why children and pregnant women are more vulnerable to EMF exposures.
  • How these human-made EMFs interact with the our body and the environment.
  • What the 3 guiding principals are to reduce your exposure.
  • Top low-EMF hacks to reduce EMF exposure from cell phone, laptops, and tablets.
  • 3 simple, no-cost steps to reducing your EMF exposure at night - drastically.
  • Trusted low-EMF devices and shielding technologies.

Included live demonstrations:

  • How much electricity couples on to you while you sleep?
  • Earthing best practices
  • Effects of wiring errors in your home
  • Exposure From WiFi and Cordless Phones
  • Exposures From CFL lights

Event Agenda - June 14, 2019

This presentation will begin at 1:00pm and end at 5:00pm. There will be approximately 3 breaks during the event, and each attendee will receive a copy of all slides for note-taking purposes.


  1. EMF Basics
  2. Science Round Up
  3. Types Of EMF and What is a safe Level?
  4. EMF Hot Topics
  5. Solutions
  6. Q & A

About Our Guest Presenter

Mitch Marchand, B.Sc. EE

7 years experience performing residential EMF inspections and assessments.

Owner And Principal EMF Consultant

Certified Building Biology® Electromagnetic Radiation Specialist

Chief EMF Consultant at Elexana LLC – New York City’s Electromagnetic Field EMF/EMI Testing & Consulting Service

Bachelor of Science in Electrical Engineering from the University of Alberta

Former Principal Engineer at Ready Engineering Corporation

9 Years Of Industrial Electrical Engineering Experience In Power Plants and Oil & Gas

Building Biology® Advanced Electromagnetic Radiation 5-day Seminar Lab Assistant in 2014, 2016, and 2018 and Featured Lecturer: How to Measure EMF Levels Emitted By Smart Meters, Data-logging for Smart Meter Measurements, and The Various Models of Smart Meters and Their Differences.

Sign Up For This Event

Fill out the form below to reserve your spot now.

Event Cost: $150 per person
Want to bring a friend? Get a 15% discount for the second person.[/vc_column_text]

Past EMF Lecture Testimonials

Mitch has put together an exemplary lecture. His information is up to date and informative. His passion for this subject shows in his presentation. Anonymous – Calgary, AB

Mitch is very knowledgeable, seminar chock full of information and practical tips. Anonymous – Calgary, AB

Mitch, I have been passively worried about all he "waves" around us but have never taken the time to investigate in more than a casual way. This was a huge wake-up call for me. Thank you. Well done and a lot of good information in a short time. Excellent. I am referring you. Please let me know when your next information seminar will be. Rick U. – Lacombe, AB

I attended a very impressive presentation and workshop held by Mitch Marchand, at EMF Awareness. Mitch gave a good succinct overview of everything EMF, and how to mitigate by avoidance, dilution, and shielding. He was very thorough and practical in his recommendations for how to live in the modern world while safely reducing EMF exposure. The demonstrations were interesting and instructive, and it's great that Mitch has all the equipment as well as the ability to put together a good demo. It was particularly impressive that he was able to cover such a broad topic in a clear manner that was interesting and useful. Participants with both limited prior knowledge, as well as participants with a technical background in these subjects, appeared to be engaged by the presentation. Susan S. – Calgary, AB

I highly recommend that everyone attend Mitch Marchand's eye opening lecture on the harmful impact that Electro Magnetic Frequencies (EMF) have on our daily lives and of our family, friends, coworkers or employees. Mitch gave us solid, actionable steps to take that can greatly reduce the negative effects of EMFs on our health and overall well being, whether in our homes or at work. Mitch's professionalism, expertise and knowledge on EMFs is remarkable. Anyone who wants to improve their health and that of their family must attend this event. -- Sandra R. Calgary, AB

It's astonishing the breadth and depth that EMFs negatively impact our health and without even realizing it. There so many steps that we can personally take in our homes and at work that can reduce the impact. Mitch is extraordinarily knowledgeable in this area and with bonafide credentials. His presentation is science and fact based, and includes measurable demonstrations that are surprising. Anonymous – Calgary, AB

A good succinct overview in everything EMF and how to mitigate by avoidance, dilution, and shielding. How to live in the modern world while safely reducing EMF exposure. Demonstrations are interesting and it's great that Mitch has all the equipment and ability to put together a good demo. Anonymous – Calgary, AB

Mitch is well informed and easy to listen to. Anonymous – Calgary, AB

I would say that attending this lecture helped me recognize at a deeper level how addicted out society is to technology and the importance of educating ourselves so that we can do some simple free or low cost things to protect us. The lecture provided cleared explanations about EMF exposures and demonstrations or suggestions about safer ways to use technology. Wayne S. Barrhead, AB