Are Autoimmune Diseases Caused by Stealth Infections?, with Dr. Steven Phillips and Dana Parish

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In this episode, we discuss:

• Why Dana Parish and Dr. Steven Phillips began working together
• Phillips’ clinical and personal experience with chronic disease
• Dana’s experience with chronic Lyme disease and the dogma and ignorance that comes with it
• The frustrations of common Lyme disease diagnoses and treatments
• Comparing chronic infections to the COVID-19 pandemic
• The vested interests of conventional medicine
• Chronic illnesses; how we got here
• Advice: power through the hard times to reach the root cause of your illness

Show notes:

Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. This week, I’m really excited to welcome Dr. Steven Phillips and Dana Parish as my guests.

Dr. Phillips is a world-renowned, Yale-trained physician, researcher, and international lecturer who specializes in the management of complex vector-borne infections. Dana Parish is an award-winning Sony/ATV singer-songwriter who has collaborated with Celine Dion, Michael Jackson, and Nick Jonas, and she’s become a powerful voice for change in the field of Lyme disease.

So we’re going to talk today about stealth infections like Lyme disease, what they may have in common with COVID[-19] and the COVID-19 pandemic, and some of the lessons that we can learn from experience [in] treating these tick-borne and stealth infections. Let’s dive in.

Chris Kresser:  Dr. Phillips and Dana, it’s such a pleasure to have you on the show.

Steven Phillips:  Hello.

Dana Parish:  Thank you for having us.

Steven Phillips:  Thank you.

Chris Kresser:  So maybe we could start with a little background. As I was reading, doing the intro, I was introducing a Yale-trained physician and an award-winning singer-songwriter. So, the first question some people might have is, how did you get together and start working together? And what are both of your backgrounds? How did you get to this moment in time?

Steven Phillips:  Well, Dana walked into my office wearing a furry vest. And she was immediately someone to take notice of. And basically, she was a patient, and I hope Dana can tell the story, but we helped Dana get well. After that, we decided together that we have to do something to change the status quo for people with chronic illness because so many people are suffering around the world with fibromyalgia, multiple sclerosis [(MS)], and rheumatoid arthritis. And these are conditions that I frequently treat. And some of these conditions Dana has been diagnosed with and myself, as well, unfortunately. And that’s how it started.

Chris Kresser:  Yeah.

Dana Parish:  Honestly, it’s a crazy story because I was [at] the height of my music career when all of this happened when I got really sick. I was bitten just a few months before I signed a deal with Sony. And I was supposed to be able to travel and write songs for all kinds of people. And all of a sudden, I was completely down, and I couldn’t find the right doctor. I had seen a dozen doctors, and somebody told me about Dr. Phillips. And I was totally blown away. [I] watched a YouTube video that he did, and I was terrified because I realized how serious my condition really was after hearing him speak. But I also knew he was brilliant and that he was going to be the one. I called his office and begged for the soonest appointment possible. And luckily, I got in on a cancellation. He had a long waiting list already. But I was local, kind of. And then we met, and we just had a very strong bond, like we’ve known each other for 100 lifetimes. And it still really feels like that. And we’re just lucky our stars aligned, and here we are. It’s an amazing, amazing journey and a shock that my life personally took this turn.

Chris Kresser:  Right. Yeah, it’s interesting to me how those twists and turns happen and how we end up where we are. So I always like to start with that question. You’ve written a book called Chronic together, which starts with the premise that a lot of the autoimmune conditions [that] are exploding in both prevalence and the number of conditions that we’re defining as autoimmune often have [a] chronic infection at the root of them. And this is very intriguing to me. Way back with my own struggle with chronic illness, I was misdiagnosed with Crohn’s disease, but during that period of time when I thought I might have Crohn’s disease, I was doing a lot of research and came across, of course, the theory that Crohn’s [disease] might be caused by [Mycobacterium avium paratuberculosis] (MAP), and went really down a rabbit hole exploring the links between different chronic conditions, particularly autoimmune, but others and chronic disease. So, Dr. Phillips, tell us a little bit about how you came across this hypothesis and what got you interested in it as a clinician and doing the research for this book.

In this episode of RHR, I sit down with Dr. Steven Phillips and Dana Parish to discuss finding and curing the root causes of autoimmune diseases and chronic illnesses, and the fight that comes with it. #chriskresser

Steven Phillips:  Yeah, thank you. I’ve been interested in this field of chronic illness for some time because it all started with my dad. My dad had a case of dilated cardiomyopathy (heart failure), which had been going on for about 20 years. And it all happened after a bout of meningitis, which they said was a virus. And looking back, it seems pretty clear that’s when his Lyme [disease] started. But his case was missed by the best doctors in all the New York City teaching hospitals, and he had progressive heart failure, despite every best medicine available, and they wanted to give him a heart transplant. And with that heart transplant, [the] mid-’90s, they said he had about six months on average to live.

And I was just finishing up my residency, and I had done research in Lyme [disease] and microbiology and immunology. And I had learned that Lyme [disease] [could] cause dilated cardiomyopathy, one of the many conditions that it can cause. And I brought it to the attention of my dad’s] cardiologist, who basically rolled his eyes and said he doesn’t have Bell’s palsy [and] he doesn’t have arthritis. He wouldn’t even test [for] them, and he’s like, you’re a doctor. Now you do it. And I tested him, and his test was, lo and behold, negative. And then I said, well, which is safer, a heart transplant or giving a few weeks of doxycycline, just [to] see if there’s a, budge the needle. And I always tell people, “Look, I was on doxycycline for three years when I had acne as a kid, and nobody batted an eyelash.” And now it’s like pulling a rabbit out of a hat to try and get a diagnosis that requires it.

So, long story short, I treated him, he recovered fully, [and] he never needed a heart transplant. [I] ended up treating him with long-term antibiotics and antimicrobials, and it took about a year for him to normalize his heart. I kept him on antibiotics for another two years. He’s 88 [years old] now, and his heart’s the strongest part of him, and that’s how I got galvanized on this focus. And then I noticed quickly, I really wanted to just think, “Okay, I’m going to treat some cases of Lyme [disease] and not pooh-pooh and dismiss, because around here in Connecticut where I practice, it’s so hyperendemic, and the cause of chronic problems. But then I realized that people were coming in with various diagnoses. They were coming in with inflammatory arthritis, rheumatoid arthritis and spondylitis, arthritis of the spine, and people were coming in with inflammatory bowel disease and MS and fibromyalgia, and chronic fatigue syndrome. Just on and on. And they would say, “Do you think I could have an underlying infection? Could there be Lyme [disease]? Could it be babesia?” We didn’t know about Bartonella at the beginning.

And I would evaluate these people and treat them, and more than 95 percent of my patients improved markedly. So I started thinking, holy moly, what is the link? And I started going down the different rabbit holes, like you went down with mycobacteria. I went down that one, as well, a long time ago. And I was really dismayed at how there was just abject dismissal on the part of the [gastrointestinal] (GI) doctors that I brought it up to. They just wouldn’t even talk to me about it. And I said, well, what’s the harm of treating with clarithromycin (Biaxin), which has activity against mycobacteria. And let’s just see what happens. And then I had my own bout. In 2010, I was sleeping in my bed, and I got spider bites, and I woke up, and I didn’t think anything of them. And I got rapidly progressive arthritis down my spine, and [it] spread to my peripheral joints.

Long story short, within six months of the spider bites, I couldn’t walk on my own, and I had to give up my practice. I went to 25 doctors, including three rheumatologists, [and] other Lyme [disease] doctors, including infectious disease doctors, neurologists, and nobody could help me. It was a really terrible story. I failed a lot of antimicrobial treatments, and they wanted to give me immunosuppressants. I ended up losing 50 pounds, I got fevers, 102[°F] every night, [and] became severely anemic. I was losing my vision from uveitis. I had extremely high inflammatory numbers, and I was bed-bound. I didn’t walk for almost two years, and I almost died on multiple occasions. And I figured it all out by a chance event, from just a chance email I got from someone asking for help. And I tried to help this person, and through that, I discovered my own illness.

Chris Kresser:  It strikes me that, of course, we’ve learned a tremendous amount over the past decades and centuries when it comes to science and medicine. But in each age, there’s a tendency to think that we’ve arrived. We’ve somehow now finally come to the truth and all of the answers. And so, even though we can look back on the past at our forebearers and chuckle at the ideas that they had, we somehow believe that now we have the answers. And there’s just, any student of history or science and medicine can tell you that that’s just folly. Because a great example is ulcers and Helicobacter pylori and the steps that Warren and Marshall had to go through to convince the medical community that there might be an infectious agent that’s contributing to ulcers. They basically had to infect themselves with the bacterium, take antibiotics, resolve the infection, [and] resolve the ulcer. And even then, my understanding is it was still years after that before that became widely accepted. So why do you think there’s so much resistance to new ideas, either of you, in medicine and the scientific community?

Steven Phillips:  I don’t know if you know what the H. pylori study, the two doctors, one from Harvard and one from Cornell also found the bacterial link to ulcers 40 years before.

Chris Kresser:  No, I didn’t know that.

Steven Phillips:  And they were ridiculed. Yeah, they were ridiculed to the point that they gave up their research. These were really well-connected doctors, and they couldn’t get it through. Yeah. So the Australian researchers were laughed off the stage initially in 1983. They couldn’t finish their presentation. And then they won the Nobel Prize, I think in 2005.

Chris Kresser:  Right.

Steven Phillips:  It’s really crazy.

Chris Kresser:  If there was only one time that had happened, that would be one thing, but there’s just a consistent series of those kinds of things. Dana, as a patient, from the patient perspective, what’s been your experience with interacting with the medical community and following your own intuitive process? What have you found in that?

Dana Parish:  Yeah, that’s one of my favorite questions because it’s a great opportunity for me to educate the general public who doesn’t know what it’s like to have a kind of mystery illness. What the medical landscape is, I mean, I find that there are two huge problems. One is dogma, and one is ignorance. And also, there’s just a lack of recognizing patterns that should come inherently to the medical community because that’s kind of part of their training. And I can’t believe how many of the same doctors I saw that failed to recognize my very obvious infection. How many other people I know who saw some of these same doctors, and never once did a light bulb go on.

But the other problem is a much larger issue. And we talk about this quite a bit in the book. There’s just no money in cures; there’s a lot of money in long-term, chronic incapacitating illness. If you’re going to, for example, I was a person, Dr. Phillips kind of alluded to it earlier, who could have very easily been defaulted to many, many autoimmune diagnoses and psychiatric diagnoses, because I also had [a] sudden onset of depression, insomnia, [obsessive-compulsive disorder], anxiety, and also I was hallucinating. I mean, crazy, crazy stuff. But I knew that it was something infectious because my brain didn’t feel like my own anymore. I just didn’t know what it was. So I easily could be talking to you on 10 medications, and I’m not on anything except a couple of good vitamins to keep my immune system healthy. And if not, I think I would have had fibromyalgia. I could have had MS. I had a lot of numbness and tingling, [and] I had a tremor. I’m just lucky that I saw the bite, and I could keep pressing for answers. And I had [a] clue with the bite and the bull’s eye that I had some kind of ongoing infection after the initial three weeks of doxycycline failed.

The other thing that’s important to say about my story is that there was a latency period. So I had a bite; I had a little rash. I was treated within a week. So there’s this whole notion that if you’re treated early, it’s super easy to cure. Completely false. I am one of many thousands of people who fell through the cracks. Three months later is when all hell broke loose, head to toe. Neurologically, physically, my whole body just felt like it was shutting down until I went into heart failure three months after that, and that’s when I found Dr. Phillips. And 12 doctors in, they just kind of left me by the road to die. And I think the dogma really held; I would get shut down as soon as I would bring up the fact that I had heard there was such a thing as a Lyme [disease] doctor. I didn’t understand that an infectious disease that’s so common could be politicized to this degree. I’ve never heard of such a thing. It’s so outrageous. And I think it’s an important thing for people to know when you hear that Lyme [disease] is easy to treat, and easy to cure, and easy to diagnose, that’s actually completely untrue.

Chris Kresser:  I’d like to touch on that briefly. We’ve talked a lot about that on other shows. So hopefully, my audience is a little bit more aware than most in that regard. But I’m curious about your experience, Dr. Phillips, for the same question on the clinical side. Because myself, as a clinician, I’ve often encountered, like you said, anything from eye-rolling to almost vitriol in the face of ideas that challenge the mainstream perspective. So what’s been your experience as a clinician in that regard? And how have you navigated that?

Steven Phillips:  I think the majority of doctor learning stops with [medical] school, and then they try to keep up with this continuing medical education, but it doesn’t work very well. I think that, unfortunately, it’s an ingrained part of our psyche. We have this conformational bias. It seems very hardwired. And if something doesn’t fit your preformed narrative, it’s very hard to take in new information. But I have to lay blame where blame is due and [this] kind of, like, the message from on high. If we look at [the] Infectious Diseases Society of America (IDSA), they are saying there’s no convincing evidence, if we just speak to Lyme [disease] for a second, no convincing evidence of chronic Lyme [disease]. And meanwhile, they’ve isolated the bacteria alive from patients literally after years of antibiotics. So if that’s not convincing evidence, I don’t know what is.

I don’t know that you need more evidence. There was a Lyme [disease] researcher who pooh-poohed Lyme [disease] for a long time, and he was quoted some almost 15 years ago saying that everything noteworthy or something like this, to be discovered about Lyme [disease] has already been discovered. And then oops, 10 years later, we realize that we can’t even kill [these] bacteria properly in the test tube with the antibiotics that are purported to kill it and cure it in people’s bodies. So I don’t know, I think it’s a frailty on our species. I don’t think we’re very highly evolved. (Crosstalk 15:24).

Chris Kresser:  Yeah. There are a lot of cognitive biases that probably helped us survive in a tribal, Paleolithic environment that work against us. Like confirmation bias, groupthink, the need to be part of a group where, if you feel like you’re not part of a group, that’s actually like the threat of death in an ancestral environment. So yeah, it’s fascinating and frustrating, and all of that. I know, we could probably talk endlessly about that. But I want to move on and relate your research on chronic infections and what you’ve learned from that to the current COVID-19 pandemic. Because there are, as you pointed out, some eerie similarities and perhaps some lessons that we can learn from stealth infections and the impact that they have on who gets COVID-19, who has a more severe infection, and then, of course, this phenomenon of long COVID. Which now, there have been papers published indicating that it may be autoimmune or that the infectious agent is provoking this autoimmune response. And isn’t that interesting in light of what you’ve been arguing about the link between chronic infection and other autoimmune conditions?

Steven Phillips:  So yeah, exactly. The issue is, there are many, many infections, multitudes literally, that provoke autoimmune reactions. And the question is, does it perpetuate in the absence of a small amount of the infection that’s leftover? If we think of our bodies as a fortress the immune system is fighting, the current model, unfortunately, says that the war is still being fought after the enemy has been defeated. And our premise of the book is that the enemy is still there. They’re like terrorists and sleeper cells with little bits of infection still lying around, kind of infiltrating the immune response and making it behave abnormally. And in the book, I think that we have our various toolkits, and one of the toolkits is a way of thinking and approaching complex chronic illness problems by detangling them, going into them like a kid would. Without the bias, just looking at the situation with new eyes, like with long COVID, for example.

So right away, the things that come to mind [are] that, number one, some of these patients are going to have [an] injury to their vasculature, the lining of blood vessels that takes a really long time to heal. But then the other ones, like Dana’s mentioned a latency period that’s particularly germane to long COVID. Because if people got over it and felt well for a few months, and then started feeling poorly again, that suggests an underlying infection. So the sum data of the virus, [SARS-CoV-2], can persist much longer than people realize is data from olfactory bulbs and data from GI biopsies. And if that’s the case, we have to realize that these are not tests that are routinely available for people just to go to their regular doctor and get tested to make sure that they have COVID[-19], the virus is still in their body because it’s not just a regular nasopharyngeal swab.

And so they should do studies on antivirals and see if some of the medicines that work for acute COVID[-19] work for long COVID. And then the other thing that people never think about, which is a big premise of our book, is that there [are] so many infections we walk around with that don’t make us sick. And people would be shocked if they knew the true number. Our bodies are like little zoos, and if you get a bad viral insult, something that throws off the immune system, it can reactivate other latent infections. And I’d seen this before COVID[-19] came around. I had patients coming in who didn’t have any known bug bites, but their history was they had a bad case of mono, or they had a bad case of dengue fever, and they just never bounced back. And when I evaluated those patients and treated them for other infections that I found, by treating the other infections, not even focusing on the viral aspect, they would improve.

Chris Kresser:  Right. This is such an interesting thing in relation to long COVID because, from the studies I’ve seen, there’s actually no correlation between disease severity and the prevalence of long COVID. And in fact, it may even be more common in people who had a mild or asymptomatic infection and people who are young and typically not included in the high-risk groups. So this, to me, is one of the scariest things about long COVID, especially because there’s really little surveillance that I’m aware of that is set up to properly track people. You just used a case where somebody has a mild infection, then two months later, they start developing autoimmune symptoms. That person is not going to be counted or studied. I think there are a few studies going on, but if they end up in their primary care doctor’s office, very likely they might get the eye roll that you, Dana, talked about, or you both talked about before. So what happens to these people? How do they not fall through the cracks?

Dana Parish:  So Dr. Phillips and I have had a unique insight into exactly what you’re saying because we have started a partnership with Survivor Corps, which I’m sure you know what that is. But for people who don’t, they are the largest group of long COVID patients in the world. And they’ve come together, as like 150,000 of them so far, to cull data and to talk about their experiences and to say this is happening to me, is it happening to you? And they’ve done a remarkable job.

What I’ve learned from them is it is exactly the same. They’re not believed. They get eye rolls; they’re traumatized by physicians and other clinicians who don’t believe them because a lot of their symptoms are subjective. So this is the problem. My opinion of how to overcome it is to bring other cases. For me, personally, what has been rewarding is to be able to go back to some of the doctors who discredited me or didn’t know what to do with me and try to teach them earnestly and not in a way that’s “I told you so.” But I brought them other case studies, I brought them articles, and I tried to get them to see what they were missing.

And actually, a couple of them have really changed their minds. I would tell patients to advocate very strongly for themselves by bringing somebody with them to their appointments. And I would tell them to keep very good notes, bring in all your questions, and have somebody there to really talk to the doctors for you and get some answers. And if you’re not being believed, I would also just say, “I don’t think you’re hearing me.” I don’t think you need to be afraid to confront doctors. I’m certainly not afraid to confront doctors at all. And it was a great way; it actually helped me a lot to find my way to the right care. Because when they answered my questions in a way that was ridiculous, which happened frequently, I knew they were not educable, and I had to move on. But the only way I knew was by asking questions.

I had an [infectious disease] doctor who told me, “you can’t possibly still have Lyme,” because, “I went to medical school.” This is an NYU infectious disease doctor, very well-known in New York City. That was his reason. And that’s an unacceptable answer, to say the least. I moved on from him really quickly. So, that’s my advice. Bring an advocate and speak your mind and do your best to move on when you need to.

Chris Kresser:  Yeah, it’s interesting [how] that spirit of curiosity, you mentioned Dr. Phillips, [is] not as common as you would hope in medicine. I mean, you both probably know Dr. Mark Pimentel, who’s an expert on [small intestinal bacterial overgrowth] (SIBO). I’ve had him on the show a bunch of times. And as you may also know, his latest theory of the ideology of SIBO, at least in a subset of patients, is that the onset is with an initial episode of food poisoning, which could be either viral or bacterial in origin, which then causes an autoimmune reaction to vinculin, a protein in the small intestine, which affects the migrating motor complex, slows down the motility of the small intestine, and voila, you’ve got bacterial overgrowth there. That’s been fairly well accepted, at least in a section of the gastroenterology world. And that’s not very different [from] what you’re arguing in terms of the origin of other autoimmune diseases.

So it strikes me that in some narrow areas of medicine, these ideas are somewhat accepted and not really that controversial. Whereas in other areas, they’re extremely controversial. And that’s what tells me politics and other forces are involved. Because if you have acceptance and rational discussion and debate about it in one area, but not in another, then there’s something else going on that’s coloring that conversation.

Steven Phillips:  Yeah, I think a perfect example of that is the hydroxychloroquine demonization.

Chris Kresser:  Yes.

Steven Phillips:  This drug has been around for 65 years, has an exceptional safety record, I think something like 55 people or something like that died in all that time, and almost all of them were from intentional overdoses of, like, the whole bottle. So, it’s not to say that it’s a cupcake and everybody should be on it, and it’s wonderful, [and] it has side effects like any other medicine, but it’s not this poisonous drug that it was made out to be. And when I saw that happening, I was like, OK, everyone’s reached a new low. No one changes since high school, and to realize that we have these is probably the big part of the problem.

Chris Kresser:  Yeah. Since we’re on that subject, you were on the front lines. You’ve had some experience treating COVID patients.

Steven Phillips:  Oh yeah.

Chris Kresser:  Tell us a little bit about that and therapeutics like ivermectin, which have popped up on the headlines. And as soon as vaccines started to take shape, we haven’t heard very much about those kinds of therapeutics since then. So I’m just curious about your experience.

Steven Phillips:  I’ve treated about 60 patients with COVID between last winter and this winter, and they’ve all done well, the ones that I’ve treated. And I’ve offered them early therapeutic options. When hydroxychloroquine was the first thing to come out, I was offering hydroxychloroquine. And then as other treatment options became available, I started offering people a cocktail of what patients had comfort with and depending on how long their illness went on before they saw me, etc. I actually had a lot of experience with hydroxychloroquine, using it for various infections because it can work for Coxiella Q fever endocarditis, it can work for Lyme [disease], and it can work for Bartonella. There [are] data out of South Korea. And I had used ivermectin as an immune modulator to help the immune response along with antimicrobials for years and years. So I had experience with that.

And it’s ironic that these drugs doxycycline, ivermectin, hydroxychloroquine, even drugs like Alinia, all the doctors, like myself have experience with these exact drugs. It’s very bizarre and ironic. So I had a comfort level with literally all of them. And my patients have not developed long COVID. And these are patients who’ve been treated early. I do have one long COVID patient. She’s a patient who I did not get the opportunity to intervene when she had acute COVID, and she started having chest pain and breathing problems for months afterward. She called other doctors, and I was like the 10th doctor that she called. And she’s like, “I don’t know if you’ll have an opinion on this, but I’m so desperate.” And I gave her ivermectin and her symptoms resolved within 24 hours.

Chris Kresser:  Wow.

Steven Phillips:  And she was good for three months. And then, just a month ago, she came back with recurrence [of] chest pain. [I] gave her another bout of ivermectin, and her symptoms went away again. So I don’t think it’s a coincidence now that she’s responded twice so markedly. And the question is, does she still have the virus present in her body? Is there truly an autoimmune phenomenon that goes on in the absence of the infection? My personal feeling is that the vast majority of times, but I can never say always, or never, I mean, who knows everything, but from what I’ve seen in clinical practice from the research we did for the book, it seems like there’s an infectious bit still left over that drives these autoimmune reactions. And these patients definitely have hope to get better. I don’t think they have to think of themselves as stuck in this condition just because people are arguing about what’s causing it.

Chris Kresser:  Yeah, I’d like to point out, too, at this point, that this isn’t just something that you just had a dream about and wrote a book about on that basis. There’s a lot of research to support the link between viral infections as triggers of autoimmune conditions, right? Yet, I’m often struck by, I can go to PubMed, I can look up all these studies, there’s peer-reviewed research published in reputable journals by A-level scientists, and yet that information has not trickled down or been communicated to working clinicians. And I’m always struck by that gap that exists. Even people, research-based institutions where you would expect them to be current with the literature in exploring that.

Steven Phillips:  When I’ve had this conversation about rheumatoid arthritis because my diagnosis [was] spondylitis and rheumatoid arthritis. I had a rheumatologist hold my hand and say the only treatment for me was a biologic[al] immune suppressant. And she said, “We as rheumatologists don’t focus on [the] cause; we only focus on the effect.” I’m like, “How do you get people better?” And she said, “Well, if we suppress symptoms for the rest of their life, we call that a cure.” And I said, “Well, use the proper word. Call it ‘palliation.’ I’m okay with you palliating patients if you can’t find a cause, but I want to find the cause for my illness and for my patient’s illness.” And so we kind of butt heads a little bit, and I do butt heads with rheumatologists on a regular basis.

But when I brought up to them that there are 12 randomized controlled trials treating rheumatoid arthritis with antibiotics, and all 12 show that the antibiotics work and placebo doesn’t, they always say, “Oh, it’s the anti-inflammatory effect of the antibiotics.” And I say, “Okay. Here’s the subset of [those] data in which they used antibiotics with zero anti-inflammatory effect. Now, how is it working?” They say, “I don’t know. It’s some idiosyncratic kind of reaction. We don’t exactly know then.” Then I said, “Okay, well, how is this subset of the data where they compared it in addition to methotrexate and steroids and show that the antibiotics even work better than that? What about that?” And then there’s nothing, no answer. It’s just a blank slate, and they don’t come back from that. Once you show that the antimicrobials are better than [the] standard of care, why are they using the standard of care? Why isn’t the standard of care changing? And [to] that, they don’t have any response.

Chris Kresser:  Well, Dana, you pointed out that there may be some other vested interests at play there. If you have a treatment that is curative, that’s not as lucrative as the treatment that can be taken for the rest of one’s life, right? And, you can look at this in different ways. And people do look at it in different ways, depending on their worldview. You could say it’s a conspiracy, and it’s intentional and explicit. Or you could say, it’s more like Upton Sinclair’s quote, “It is difficult to get a man to understand something when his salary depends upon his not understanding it.” Which is one of my favorite quotes that I think explains a lot.

Dana Parish:  I think we put that in the book.

Chris Kresser:  Good. So, which is to say that there isn’t maybe malice or even conscious denial happening there. It’s more just like something that background [noise], “la, la, la, la, la, I’m not going to pay attention to this,” because if I do it, it might threaten me in some capacity, whether it’s financial, reputation, [or] otherwise.

Dana Parish:  Well, it’s astonishing to hear what doctors and other scientists, PhDs will tell us off the record versus what they’ll tell us on the record. And we interviewed so many people for the book; I don’t know that we were shocked by that much. I will just say that we got a lot of confirmation for a lot of things that we’ve seen and that we’ve been thinking. I don’t think it’s always malice, and I don’t think it’s a conspiracy because I think it’s actually true that this is going on.

So when people tell me that, I can point to, for example, just Google Merck Vioxx and hit list, and there’s a huge lawsuit that happened. You can find it on CBS News and BMJ; you can find it all over the place, all these articles about how when doctors discredited Vioxx because it was killing so many people, and they were so afraid of it and wanted to stop using it, they created a hit list of doctors to go after and discredit or neutralize them as they put it in the lawsuit. I was just rereading this yesterday, to get them to be quiet. And I actually think that this kind of stuff, to some degree and on varying levels, still happens. It’s really serious. And I’m seeing it right now again with ivermectin. Merck owns ivermectin, but it’s a cheap generic drug. People don’t realize that they’re discrediting it, perhaps because they have a new therapeutic. And I just was reading about it this week. A CNBC reporter was reporting on it. And these shiny new patents make billions and billions of dollars sometimes; generic drugs don’t.

So [it’s] very, very upsetting to watch a cheap, generic, safe, effective drug within 80 percent mortality benefit be ignored in favor of remdesivir, for example, which is $3,200, and has no mortality benefit. I think you have to keep looking at these things for what they are. That’s the truth of it. Make of it, deduce what you will. But that’s my strong opinion about it.

Chris Kresser:  Right. You can even look, these are public corporations whose officers have a fiduciary obligation to maximize profit. So without getting into a whole political or economics discussion, that’s one way of looking at it. Right? They’re just doing what they’re set up to do. And, of course, that leads to a whole other discussion about is that the best structure and format for medicine? And is that the best way that it works? I see, we don’t have video on right now; I see some heads shaking.

Steven Phillips:  Listen, I always thought the pharmaceutical industry needed to be highly, highly regulated because they did an analysis of Harvoni, the drug that effectively gets rid of hepatitis C in the vast majority of patients. And they basically said, this is not a good business model. And this article was published. I was shocked to see the article in print. And someone to admit that wow, we’re not going to look for cures anymore when everybody whispers that they’re not looking for cures, and they actually put in an article.

So it’s not just implicit; this is an explicit strategy, I believe, that they use. And this is something that’s obviously come up in discussions for them to write a whole article about it.

Chris Kresser:  Yeah, I can’t remember what book this was in, but the former Merck CEO was on [the] record, I think it was related to statins, and he said, “We’ve basically exhausted the market for sick people. So we need to start figuring out a way to sell drugs to healthy people.” That’s where the real opportunity lies because that’s a much bigger audience of people. So let’s get people on all these drugs for primary prevention. And that was the new territory.

Chris Kresser: All right. So, going back to the topic of chronic illness in general, you have tens of millions of people now suffering from autoimmune disease. I can barely keep up with the statistics. Over 80 diseases have been classified as autoimmune in origin. As a clinician, I’ve thought a lot about this. What do you think is going on here with chronic infection? Clearly, well, I don’t know. I shouldn’t say “clearly.” My sense is that this is a problem that has increased pretty significantly over the past, let’s say, 50 or 60 years, and it’s not new that we’re exposed to these pathogens. It’s not new that people are getting tick bites, and Lyme [disease] is being transmitted. So if we think about the whole ecosystem, what do you think is going on here that’s making these infections more pathological and more capable of inducing these systemic autoimmune effects?

Steven Phillips:  Right. It’s the notion of seed versus soil. These infections are ubiquitous. Like I said [and] like you said, so many of us are carrying them around. In the olden days, we didn’t get sick like this. What’s changed? And obviously, it’s some environmental change going on. We’re exposed to a much more toxic environment [than] we used to be in 50 years ago. And I’m not exactly sure. I think that it’s probably a combination of events. People talk about the overly processed foods and the contaminants maybe that are in pharmaceuticals. And we go down a couple of rabbit holes, like we talk about the toxin [beta-N-methylamino-L-alanine] (BMAA) from cyanobacteria linked to neurodegenerative conditions. And clearly, that’s not an infectious route. There are toxic exposures. But I think it’s more of a threshold effect between something that’s toxic exposures plus these infections and spilling us over into illness versus good health. I think that people are not aware of what a fine line it is between health and disease. And it doesn’t take much to spill people over.

There are a couple of ways to approach the problem if somebody has things from a Functional Medicine standpoint. I’m not a Functional Medicine doctor, but I certainly, when I was sick, I saw 25 doctors, including Functional Medicine doctors. I saw everybody. And it made sense to me what they did. They wanted to clear me out. [It] turns out I had very little heavy metals, which I was shocked at because of a mouthful of fillings, like the bad kind.

Chris Kresser:  Right.

Steven Phillips:  And I figured I must be loaded, but I didn’t have any. And they got me on a really clean diet. I think that helped to a degree, but without the antimicrobials. I still think that I would not, I know I would be disabled and possibly dead. But I’d be disabled for my life. And I had 24-hour home care, I couldn’t lift my arms against gravity, [and] I couldn’t turn over on my own. I was not just disabled from my job. It wasn’t just that; it was somebody who’s on death’s doorstep, literally, and I came back from that. I have a full life, and I’m fully functional. And I run around like a crazy person. And I have to think, where would I be if I was on immune suppressants for the rest of my life? What a horrible existence I would have had if I didn’t come to the answers.

Chris Kresser:  Track this down. Yeah.

Steven Phillips:  Yeah. And it wasn’t Lyme [disease]. Everyone’s so focused on Lyme [disease]. And yet, in the book, we go down and explain the myths about Lyme [disease] and focus on it in the first half of the book a lot because people have these preconceived notions. Then we branch out into all these other infections. People don’t realize that parasitic infections are common in our population. And they usually don’t cause illness, but they’re a bit immune suppressive. And like you said, though, these rates of infections probably aren’t changing very much over time. There’s going to be some increase in exposures to Lyme [disease] in the northeast where there’s deforestation stuff, and the deer are in everybody’s front yards now. But I do think that it’s the levels of toxic exposures that we have are paramount.

Chris Kresser:  This is to me, like one of the things I realized in my own journey, and I’ve talked about a lot is that illness is not just an individual phenomenon. We live in a context, right? So we can speak about our own choices and things that have happened to us as individuals, but we also have to consider the larger context. I grew up at a time when kids were given antibiotics like candy, and I didn’t have any choice over that when I was a kid, and that wrecked my microbiome.

And I also grew up at a time when the idea was that formula was superior to breast milk. So kids weren’t breastfed a lot. We all live in a time where water is more polluted, air is more polluted, [and] there are toxins that are persistent in the environment. Processed and refined foods are ubiquitous in people’s diets, and all kinds of medications adversely impact the gut microbiome. And I tend to agree, it’s just probably not any one of those factors, but all of them together, that then weaken the foundation of the system to the point where these infections, which have always been with us.

If you read, of course, you’re both familiar with the hygiene hypothesis and the old friends hypothesis. Not only have these infections been with us, they may have actually had a beneficial impact on our immune system in previous environments. But now, in the current modern world that we live in, they’re just overwhelming for people.

So, Dana, I want to shift gears a little bit and hear a little more from you, from the patient perspective, before we wrap things up, just some final tips. It’s so hard for people, and I’ve been there myself; all three of us have been in the situation of having a debilitating chronic illness and seeing 10, 20, 30, 40 doctors, top specialists everywhere and still not feeling like you’re getting the answers that you need. So what would you suggest for somebody in that situation, how to keep going, how to advocate for themselves, how to get [the] support that they need? Because as we all know, it’s an extremely challenging situation to be in.

Dana Parish:  Yes, I totally agree. And it’s a very hopeless place; it’s a very isolating place to be that sick, and especially from my point of view, it happened so quickly for me that my life was completely great and normal one day, and the next day, I was obliterated.

One thing that I think is really important, and I know that we’ve touched on this already: get to the root cause. Everything has a root cause. I’m not saying it’s always an infection. It could be something totally different. And I think you should also be ruling out other cancers and diabetes and other big diseases. Again, I don’t want to focus entirely on infection, although I do think tons and tons and tons of illness[es are] driven by infection and all kinds of infections. And a lot of the common ones are aligned, Bartonella, Babesia. So I would say, ask your doctors why do I have this? Why do I suddenly feel like this? If that’s the case. Or why am I this slow-boiling frog?

Again, I would suggest that people bring an advocate with them to help them through this process. I would also suggest eliminating negative people from your life, at least during that time. There were a couple [of] people in my life who didn’t get it. And I don’t know that they didn’t believe me, but I will tell you that their input was not helpful ever. So even one of my family members, not an immediate family member, but an extended family member, kept getting involved, and it was extremely unhelpful, and extremely upsetting to me, because I knew that I was finally on the right path and I didn’t want any interference.

So that was really important for me to just stay focused. Also, I gave myself permission to say no, for the first time in my life. A lot of us are people that like to say yes and like to do lots of things and achieve a lot of things. For me, this was a period where I couldn’t do that much and I had to really feel comfortable with saying, “I’m sorry, I can’t do any of that.” And that meant saying, “No, I can’t work with Idina Menzel for the next six months.” And that was very painful for me, in the middle of my career and in the middle of all this great stuff. It was very hard to say no.

But I would just tell people, it’s okay. There is a way through; there might be light right around the corner, and if you don’t hang in there, you’re never going to know. I do believe, like Dr. Phillips always says, where there’s life, there’s hope. I really believe that. I’m living proof. He’s living proof. You are living proof. And so many people living through this just need to know, we are out here pulling you through. We’re out here sending you every piece of wisdom that we have in giving you all this. We wrote this book as a labor of love because we felt so strongly that we wished we had this book when we were both so sick. So I would just want to say to your listeners, you can get better, and please hang in there. And I know how depressed you must feel when you’re going through it. I was there, too, but I’m better.

Chris Kresser:  That’s a great note to end on. So the book is Chronic: The Hidden Cause of the Autoimmune Pandemic and How to Get Healthy Again. It’s on Amazon. Tell us where they can find it. Anything else they should know about the book?

Steven Phillips:  Sure. So we have a lot of great endorsements. Sanjay Gupta endorsed our book, as did George Church from Harvard, who’s a professor there. He’s noted as the father of the human genome, and a long laundry list of …

Dana Parish:  And David Perlmutter, who you probably know very well.

Chris Kresser:  Yes. I know David.

Steven Phillips:  Yeah, and just the whole list of great-selling authors and scientists. And we’re just so thrilled that it’s been embraced by mainstream medicine, because these are controversial, innovative topics, and it’s hard to walk this fine line of having it backed up by bulletproof science, and nobody could say boo to it. So that’s why it took almost three years to write. We also want to tell people there is a COVID[-19] chapter, and the COVID chapter for people that buy the hardcover book is available as a free download. And it’s part of the Audible download now. And then it’ll be part of subsequent printings of the hardcover in a little while, but they’re just selling it on the first printing.

Chris Kresser:  Great.

Dana Parish:  It’s on Kindle, too. I should say, it’s on Kindle; it’s already on the eBook, as well.

Chris Kresser:  The COVID[-19] chapter is on Kindle.

Dana Parish:  Yes, if you got the hardcopy, which, unfortunately, due to the pandemic, it was impossible to reprint the hardcopy. So we are giving them on TheChronicBook.com. You cannot miss [it], right at the top it says “COVID chapter.” So you will have that chapter in your hands in two seconds if you want it.

Chris Kresser:  Great. Yeah, I highly recommend this book. It’s vital information for people who are living with any kind of chronic illness, especially those that are autoimmune or mysterious in origin. I think those are the ones that are most likely to benefit from this lens and really better understanding the root cause of these conditions and offering some hope and being able to treat that and really make a difference in people’s lives. So thank you both for doing this valuable and important work and for coming on the show to talk about it.

Dana Parish:  Thank you.

Steven Phillips:  Thank you, Chris.

Chris Kresser:  Thanks, everybody, for listening. Keep sending your questions into ChrisKresser.com/podcastquestion, and we’ll see you next time.

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