188 | Epstein Barr, Stealth Infections and Hashimoto's Hypothyroidism

Dr. Steven Noseworthy: when it comes to viruses, you have to ask yourself the right question. And the right question is not do I have a virus? The right question is do I have control? of the viruses that I picked up when I was young. Yes. Hey guys, and welcome back to the Inflammation Nation. If you are new here, make sure that you hit subscribe or follow right now so that you don't miss the latest episode. Right now, the biggest trend that's keeping the internet marketing machine spinning is kind of an obsession with what are commonly called stealth infections. And that's actually really a valid term. If you scroll through TikTok, Instagram, even YouTube Shorts these days, you're going to see a lot of Talking heads and influencers that are preaching essentially the same gospel, right? They're convincing millions of frustrated healthcare consumers like you to take a do-it-yourself approach to their complex illnesses. And they tell you that your unyielding brain fog, your chronic fatigue, your joint stiffness, these are entirely driven by active raging infections, whether that's Epstein-Barr virus or chronic Lyme disease or mold or parasites. And their solution is commonly a one-size-fits-all, you know, sometimes like a 30-day herbal purge. And they sell these antimicrobial killing blends that basically, you know, try to blitz your immune system. And they sell these right off their their Linkin BIOS. And when these intense protocols leave you feeling like absolute garbage, they hand you the ultimate clinical get out of jail free card, which is, that's just a a detox reaction. It's a Herxheimer reaction or it's a die-off reaction. And if you feel bad, it just means that the protocol is working. And to be honest, there is some truth to that, right? Sometimes that actually is the right answer, but a lot of times it's not. So we want to do a little bit of a clinical reality check. feeling worse during a protocol isn't always a die-off reaction. It's not always that Herxheimer reaction that people Talk about it. Sometimes it means you're burning down the house just to kill a spider. That's the clinical reality. And so, you know, like going on an antimicrobial killing spree in a body that's already chronically fatigued and chronically inflamed and immunologically incompetent is sometimes a pretty good recipe for a systemic metabolic crash. And I've said this on episodes before that good strategies. often fail in functional medicine simply because they're the right thing at the wrong time or simply done the wrong way. And just to run the risk of beating a dead horse, you can't out medicate, out-supplement, or out-hack a frozen and fractured metabolic foundation. And don't get me wrong, I am all for people taking ownership of their health, right? Everybody should, but sometimes that means working In some capacity with a well-trained functional medicine expert. And that's especially the case. If you happen to have a stealth infection, something like Epstein Bar or some other virus that likes to hide out in your tissues. when I was young and I was just starting to get into lifting weights and fitness, I I would buy the latest episode of Muscle and Fitness magazine, and I would read it. Cover to cover. And I would look at the routines that pro bodybuilders use to build world-class physiques. Not that I was trying to become a bodybuilder, but I made the mistake of thinking that for me to get bigger and stronger, I had to do what they did because they were the professionals. And, you know, to be honest, it nearly killed me. And I had no business replicating the training routine of a professional whose only job in life was to train and sleep and who was. probably pharmaceutically enhanced to boot. In other words, there was a mismatch between what I needed and what I thought I needed. And many of you guys are doing the same thing with your health. In the last episode, I I talked about why it's not always a good idea to just jump into longevity hacks that these online experts talk about when you haven't gone through the process of shoring up your foundation. And there are steps to take to solve your current metabolic challenges Before it makes sense to focus on long-term health. In other words, you need to build a foundation before you can throw some walls up and put a roof over your head. Today I'm gonna talk about something that is part of that foundational aspect, like the things you have to do before you can do other things. And that is these the idea of stealth viruses. And and I'll probably end up using Epstein Bar as an example, as a representative example, that you know, certainly All viruses that fall within the herpes family, and Epstein bar is a type of herpes. And just to be clear, not all herpes viruses are sexually transmitted. Just to clear that up. So I don't want you to freak out if we talk about herpes or if you think, my gosh, I might have herpes. But we're going to talk about stealth viruses and what's called viral latency. And again, I'll probably use Epstein Bar because it's the one that most people are familiar with and might talk about. And I'm gonna go through a core few core concepts and just you know, fair warning ahead of time, it might get a little sciencey today, just because it's difficult to talk about the things that I want to share with you today without bringing in a little bit of technical jargon. and I'll do my best to just kind of walk you through that just to so that you understand what's at stake and and what you need to think about. So the core concept number one is when it comes to viruses, is that everybody has a viral load. Every single person. when I teach the immunology section, like or I should probably say the functional immunology section of my functional medicine seminars, I tell doctors that it's never a question as to whether or not their clients have a viral load, because we all do, right? It's a question of whether or not we have control of the viral load that we've been carrying for most of our lives. And if we look specifically at Epstein Bar virus, the typical North American Picks this up by the time they're 20 years old, right? And if we look at a random sample of adults taken from any country in the world, about 95%, certainly over 90% of them, are going to show evidence of Epstein-Barr virus on a blood test. And that means that for you, if you're in North America or any of the developed countries, really, there's at least a 90 to 95% chance that you have st Epstein bar, and maybe you don't even know it. Now you might be thinking, well, Epstein Barr, that's the virus that causes mono or mononucleosis, right? And I never had mono, so this is not applicable to me. broadly speaking, only about 20% of people who carry the Epstein Barr virus actually get an acute infection. So that means that about 80% of the time you pick up Epstein Barr in childhood and you don't get mono. And so you can have Epstein Bar as part of your current clinical situation, your current set of symptoms and things that are changing your quality of life. And it doesn't matter if you had mono in the past or not, there's still an 80% chance that Epstein bar is an issue for you. And so not getting mono as a teenager or as a young adult doesn't mean that Epstein barr can't live in your body and then eventually reactivate at some point in life and then start to cause problems from that point forward. And in fact, it frequently does, especially if you have inflammatory and immune-based symptoms. And certainly this the higher probabilities are higher if we're dealing with autoimmunities like Hashimoto's disease, for example, or multiple sclerosis and and so on. So other viruses kind of show the same pattern of being widely distributed among the adult population. and we pick up most of these when we're young and we carry them all over our lives. And this applies to the entire family of herpes virus viruses, including Epstein-Barr, herpes simplex one and two, herpes zoster or shingles, herpes human herpes virus six, which is a big one in autoimmunity, and it can even mimic mold and Lyme disease. And just to name a few more of these stealth pathogens that might not be actually Coxacky virus is part of the human herpes virus as well, but other stealth pathogens would be. Adenovirus or human parvovirus and chlamydia pneumonia and mycoplasma and even streptococcus does kind of the same thing, although it might use different strategies. So other stealth infection like Lyme disease and co-infections like Bartonella, Babesia, that's an entirely different conversation and they evade detection in other ways than what the human herpes viruses do. But in fact, all of the stealth infections that I just named, use these very sophisticated strategic ways to evade detection by your immune system. And they like to live in certain tissues and certain tissue reservoirs as the terminology that the medical literature uses. And it honestly would take too long to go through all of that in detail. So suffice it to say that these organisms can infect joint and cartilage tissue. They can infect heart tissue, your pancreas, your liver, your nervous system, and a wide spectrum of both red and white blood cells, including things like T cells, B cells, and natural killer cells, which are necessary to get rid of the infection. a lot of these viruses infect your own immune system. They can also infect the mucosal tissue in the lining of your gut and your throat and your entire respiratory system from your nostrils to your sinuses and all the way down into your lungs. And if I can take a moment to zero in on one specific group of you guys that are listening, let me talk to those of you who either suspect or know that you have Hashimoto's hypothyroidism. There are perhaps five viruses that have a tendency or let's say more of a tendency to infect and affect the thyroid tissue than others. And I'm gonna put this up on the screen. And in fact I've got several things that'll put up on the screen during this episode, just in case you happen to be watching on YouTube. And if you're listening on Apple or Spotify and you like to see visuals, you might want to check this out on my YouTube channel. But going back to this idea that there are are five viruses and this is this list is not a inclusive of all things that could infect the thyroid. It's just that the literature says that these are the most common ones. The most common one is something I mentioned a little bit ago called Coxactivirus. I think I may have misspoke earlier where I said cocsactivirus was part of the herpes family. I'm I meant to say cytomegalovirus. Coxactivirus is actually part of what's called the enterovirus family. so Coxacy virus is one. Then we have two herpes viruses, which is our Epstein-bar virus and the human herpes virus six. And then the other final two are hepatitis C and coronavirus two, or SARS-CoV-2. And the estimates in the literature are that to up to 53%. It depends on the study and which virus you're looking at, but up to 53% of people with Hashimoto's may have a virus. Hiding inside the very cells that make thyroid hormones. These are called follicular cells. And this can both trigger Hashimoto's, like it could be the inciting event. You get an infection, it gets into your thyroid, and that causes the immune reaction that we call Hashimoto's disease, or it can perpetuate the Hashimoto's autoimmune thyroid condition if the trigger was something else. And so, for example, you can get, Hashimoto's for some other reason, but if you harbor some of these Chronic-relatant viruses that then at some point reactivate, they're going to make your Hashimoto's worse. Not that they caused it, but that they perpetuate it and perhaps promote the autoimmunity against their thyroid. And we can insert any other tissue that's subject to an autoimmune reaction there. If there's a viral load, you're going to tend to have more, you'll have more of a tendency to have tissue flare-ups. And since these viruses do like to hide out in a wide variety of tissues and cells in the human body. If you have any of these stealth pathogens, then you create a wide range of symptoms, including those of Ahashimoto's flare-up in our core example here. So I could just kind of keep talking at the the superficial layer here, but let me just give you a few takeaways from what I've said so far. First is when it comes to viruses, you have to ask yourself the right question. And the right question is not do I have a virus? The right question is do I have control? of the viruses that I picked up when I was young. And it's not just Epstein Barr, all the viruses that I've listed, with the exception of Lyme and the coinfections, the vast majority of them we pick up in our youth, the vast majority. Like some of them might be, yeah, by the time you're 40, you're likely to have it, but the vast majority are are well below that. So that's the first thing. Ask the right question. Do I have control of the viral load that's already inside me? The second takeaway point at this juncture is that immune-competent people spend their entire lives carrying a viral load inside a wide range of tissues and cells without any real problems. But it's because their immune system is competent, not because they don't have a viral load. Whereas Immunocompromised people, and by that I don't mean someone with AIDS. I just mean their immune system is incompetent. It's not doing the things that it's supposed to do. They struggle with the same viral load. And most of us, because we all live in the same world, exposed to the same thing, we all are subject to picking up all of the same viruses and and other organisms. So again, when I say immunocompromised, I don't mean like the AIDS patient. I just mean someone Whose immune system is dysfunctional or imbalanced. And that probably refers to most of you guys listening here today, right? People with chronic inflammatory, perhaps autoimmune conditions like Hashimoto's hypothyroidism are going to struggle more with the same viral load that, say, your neighbor has that doesn't have the same immune-based problems that you have. And the third takeaway is that since for most people we're talking about long-term and chronic viral loads. We can't expect these viruses to behave the same way as if you had a first-time acute infection. Right. And this is one mistake that I see healthcare consumers making is that, like, you know, someone might suggest to you that you have Epstein Barr, or maybe you have a blood test that says, hey, I've got a positive human herpes virus six. you might research those things and look at at a list of signs and symptoms online, but these are Always written from the perspective of recent or acute or newly acquired infections. They're never written from the chronic standpoint. And the reality is that low-grade chronic latent or stealth infections don't act like the recent acute first infection. The main consequence in the chronic setting is some degree of low-grade, let's call it smoldering inflammation and immune dysfunction that usually doesn't create virus. Specific symptoms, but rather through the inflammatory cascade, amplifies your entire symptom picture, which is unique to you, not the virus. So let me say that again because I think it's important enough to repeat at least once. The symptoms of a chronic latent viral load are sometimes not specific to a certain tissue, a certain system, and the inflammation from the low-level infections amplifies your general symptomatology. So for example, for most people with an Epstein Barr reactivation, I don't expect to see mononucleosis. I don't expect to see that. I expect a flare-up of their general list of symptoms that again are unique to them and not unique to Epstein Barr. Okay, so let's move into a couple of more concepts here. And I want to answer a couple of simple questions, like, hey, what is a virus? How are they different, say, from a bacteria? And how do they live rent-free in my body? Well, the first thing to know about viruses, other than you you have them, is that they're not the same as bacteria. They're different organisms. And this is one reason why antibiotics, which are designed to kill bacteria, don't work on viruses. And in fact, if you go to a medical doctor and you walk in with a cold or a flu, there's 80 plus chance that it's viral. And if they offer you an antibiotic, either they don't know what they're doing. Or according to some studies that have been done in the past, they feel like they should do something. And so they just offer an antibiotic. And then sometimes they'll say, well, go on the antibiotic in case you get a secondary infection, like a secondary bacterial infection, which certainly can happen. But on its face, it's just not the right thing to do. Antibiotics don't kill viruses, period. So Here's the key difference between bacteria and viruses. Bacteria are living organisms with their own metabolic systems that let them make energy in the form of ATP. You've heard me talk about this before, and their own proteins for building block and repair. So they they are metabolically active, they're living organisms and so on. Viruses are not. Viruses are not even alive, if you can believe that. They they actually They lack the metabolic machinery to make their own energy, and they can't make their own proteins for even replicating or duplicating the cells. In reality, viruses are simply small fragments of either DNA or RNA. It's genetic material. That's what a virus is. It's a small fragment of either DNA or RNA. And what viruses do is they infect cells and they Hijack the cell's own genetic and metabolic machinery for their own purposes. They use that host cell's DNA to replicate. They make multiple copies of themselves, and those can either persist within that host cell or they can break out of the cell to infect other cells and repeat the process. But a virus is not alive in the sense that a bacteria is. Here's a useful analogy: a bacterium. Is like a self-driving car. It has its own engine, fuel system, and navigation. And a virus is like a carjacker. It has no car of its own, no engine of its own, but it carries the tools to break in and take over and drive somebody else's vehicle. That's that's probably a good analogy. Another one would be a computer virus, right? A computer virus can't do any damage unless it's installed into an operating system. Right. If I have a thumb drive and have a virus, a little piece of software code that's considered a virus on my thumb drive, that doesn't do anything until I plug that in and install that into a computer. And once a virus infects your computer, it takes over or it just starts to mess stuff up. Now you might be thinking, well, that sounds like it's probably these viruses probably kill the cell, right? But that's not actually always true. And in fact, it's against the virus's own self-interest to kill the cell that it is infecting. Sometimes it's true, yes, sometimes the cell does die, but there are actually several different fates, if you will, of virally infected cells. And one is cell death, and that can occur through different mechanisms. The cell can explode from the inside under the pressure of more and more viruses replicating inside it, just kind of like trying to stuff too much stuff into a plastic bag. The bag rips and tears. it can cause the cell to self-destruct as the cell tries to prevent the virus from spreading. Or the virus can create so much inflammation that the inflammation itself causes cell death. So, yes, sometimes when a virus infects the cell, it causes the cell to die. But that's less common. Another fate is where the virus actually keeps the host cell alive, but it hijacks enough of the internal machinery. And devotes it to replicating themselves and promoting more infection. And this reduces the functionality of the cell itself because you're stealing resources away from the cell to promote the virus. And the cell then spends more and more time and energy doing the will of the virus rather than what the cell itself was programmed to do. This would be like some kind of an alien invasion story where an alien sucks onto somebody's face. And takes over the host and basically is the driver in the driver's seat. Another fate is one probably the most significant from a clinical perspective. And that's when viruses actually reprogram and exhaust populations of different immune cells. And viruses have very, very sophisticated ways, sophisticated ways of doing this, affecting the behavior of the immune system. And it also depletes their resources and creating a process. Virus environment, meaning that over time, the immune system loses the population of cells designed to kill viruses, things like cytotoxic T cells or natural killer cells. And the virus produces chemicals, or the virus causes the cell to produce chemicals that drive low-grain inflammation and what's called immune tolerance, meaning that the immune system looks at the virus and doesn't really care that it's there. And the final fate that I want to touch on is where the cell survives and the virus goes dormant and actually stops replicating. This is the a concept called latency. And you may have heard me talk about talk about latent viruses or latent infections in the past. But this concept of latency is something that I want to go into next so that you can understand why it can be so confusing, confusing, not just for you, but for your clinicians, to look at a set of labs and Look at, say, an Epstein-Bar panel and come to the wrong conclusion as to whether or not it's a problem. But the key insight is that killing cells is actually the least sophisticated thing a virus can do. And for many clinically important viruses, it's not even the primary strategy, right? The most successful viruses, from the virus perspective, of course, are those that keep the host cell alive and reprogram its function and evade the immune system and establish. A chronic state of low-grade inflammation and immune dysregulation. And this chronic sub-threshold inflammation is sufficient to recruit regulatory immune cells, but insufficient to clear the infection. It's a stable state of dysfunctional equilibrium, if I could use those terms altogether. All right, another core concept. How do these viruses persist? I said earlier or posed the question: how do viruses live rent-free in our bodies? Latency is one way. Another way is called immune evasion. We're not going to go through the the specifics of that because I'm going to focus now in on the herpes family of viruses and the main strategies that things like Epstein Barr and Herpes simplex and cytomegalovirus and human herpes virus six, things that these all share in common as to how they can live rent-free in your body, right? So this concept of latency, it's very complex, but It was first described in the medical literature back in the nineteen twenties. So this is not a new concept, but it's an old concept that has continued to be studied for the last hundred years. And every decade decade or so they figure out more of how these latency programs start to work. Right. So our understanding of this has developed in stages over the last hundred years. And and most of the breakthroughs came around the turn of this century, around around the year 2000 or so, give or take. And Again, researchers continue to refine this with the most recent papers giving us a lot more clarity coming, say, within the last five years or so. Now, having said that, this concept of latency is not well understood by most practitioners. Functional medicine doctors are much more likely to embrace the idea that viruses like Epstein Barr or human herpes virus six and so on can persist in your body and periodically reactivate. And it's not unusual for a funk med doc like me to declare a stealth virus as an active problem where a medical doctor would look at the same set of labs and the same history and symptoms of the person we're working with and say that this was just evidence of immunity from an old infection. So why the disconnect? Well, the first point of contention is how we interpret lab data. But I need to save that for later. And it It can get very nuanced, particularly with the Epstein Bar virus. But I I think the main issue is that most doctors are trained to think that for an old infection to be reactivated, there has to be active replication of the virus. It's kind of a binary state, black and white, yes or no. The virus is either either dormant or it's active and replicating, making copies of itself and try to expand the infection. And this would be indicated by two things on labs: a rise in an antibody type called IgM, and a viral count, like a PCR test, that is higher than baseline, right? So in the conventional medicine world and conventional immunology, they look for those two things, like a higher PCR count over baseline and an elevated IgM antibody test type. So if you went to your medical doctor with suspicions of an Epstein Bar activation, they would run an Epstein Bar panel. But if you didn't show an IgM antibody response, you would be dismissed. Well, it's not an active infection. Now, in in the interest of transparency, I'm I am fudging this a little bit because Epstein bar testing is quite nuanced. and individual doctors might differ. This is just kind of the general trend in conventional medicine, but Just kind go with me for the moment. If you did have an IgM type result, then they would order a PCR-based viral count and then repeat that maybe in a couple of weeks to see if the viral count is going up. And if you have an IgM antibody and two weeks later your viral count is higher, they're going to say, well, this is an active infection. But here's the problem. And here's where understanding latency programs and current research comes into play. And it and it turns out that again, Epstein Barr and all of the herpes viruses run four different latency programs, and they're labeled latency zero, one, two, and three. And I'm gonna throw a graphic up on the screen for those of you guys who are watching in a visual medium. So let's start with latency zero. latency stage zero. Represents the situation where we have healthy people who are carrying some kind of herpes virus like Epstein Barr, but they have healthy and competent immune systems to keep that in check. And in this stage, the virus is essentially in your cells, scattered throughout your body, but it's essentially asleep. It's really not doing anything other than surviving and quietly resting. In latency stage one Epstein Barr and other herpes viruses, I'll probably just refer to Epstein Barr from this point forward. It's still sitting quietly inside your cells, just hanging out, not messing with anything, but it's preparing to become active, but it's not active yet. It's a preparatory stage. And it's still immunologically and clinically quiet. There are similarities, of course, between latency zero and latency one, simply because there's no clinical manifestation. Latency three, I'm going to skip two here for a second, but latency three, that program is where the virus now is actively replicating. And this can, in some cases, mimic an acute infection. But remember, in the chronic setting, when a virus reactivates, the symptom picture is more about you and amplifying what you're already experiencing than recreating the symptoms of an acute infection. And this one is much easier to recognize. And your medical doctor and I would completely agree on the lab findings for this one. We wouldn't have any discrepancy. But the problem is, and where we run into trouble is this idea of a latency two program. Remember, there's four: zero, one, two, and three. Three is where it's fully active and the virus is replicating, trying to spread the infection. In latency program two, the virus is active, but it's not replicating itself. The virus uses the host cell to make regulatory proteins that shift your immune balance into a state of inflammation and dysregulation, and which can exhaust the very cells the immune system uses to try to kill them. But it's not actively replicating, which means it's not going to show up on labs as an active infection. That's because the immune system still doesn't see it. And what's important to know about latency too. Is that there is no active viral replication. So the virus is active in the sense of causing inflammation, causing immune dysregulation, causing immune cell exhaustion, but the infection isn't growing in the sense of the active replication. And it's not going to change your labs to show an acute infection, which means that the classic old school guidelines of how to interpret Epstein-Barr virus testing is ill-equipped. To discover and understand a viral load that's running a latency 2 program. Now, just in case you've had an Epstein Barr virus panel done, or if you happen to be a practitioner who's listening, because I know I do have a lot of practitioners listening, let me quickly go over what makes a good Epstein Barr virus panel. It's pretty much universally agreed upon. There are three markers, and I will put this up on the screen for you. There are three markers. One is called the EBV or Epstein Barr virus VCA, that stands for viral capsid antigen. There's what's commonly called EBNA, EBNA, that's the Epstein-Barr nuclear antigen. And then there's the Epstein-Barr virus early antigen. Sometimes it's just abbreviated as EA or EBVEA on your labs. And again, I'll throw a graphic up on the screen for you. EBNA. EBNA is expressed in all three latency stages, and we can't use that to distinguish any of them. So if eBNA is elevated, doesn't matter how high it's elevated, we can't tell if the virus is in latency stage zero, one, two, or three, because it's expressed throughout the entire one. In essence, the Epstein-Barr virus blood test is actually really only helpful in two clinical scenarios. One is finding an initial acute infection. And the other is finding a full-blown reactivation when the virus comes out of latency two programs into the replicating stage of latency three. So you know two times that this test is actually helpful for us. All the other times, and all the other people out there that are suffering from active but not replicating latency stage two infections, the labs don't help us. What the test can't do is find Epstein Bar and other herpes viruses in their active stealth mode, where the virus is present, but it's not replicating, but most certainly has hijacked your cells and is actively messing around with your immune system. And that is the very nature of the latency 2 program. These are the hardest to find, but They're perhaps the most clinically meaningful. And I can't tell you how many clients I've worked with over the years who fall into this category of complex and chronic inflammatory symptoms and who have done the gut cleanses and the detoxes and the whatevers, and maybe even had labs, and they never really progressed. They got stuck at at a plateau of recovery, and they didn't overcome that until we Dealt with their viral latency. Now, of course, you might be sitting there going, like, my gosh, yes, that's me. Tell me what to do. And I wish I could. I really do. But first of all, I'm I'm not going to do what social media talking heads do and offer a one size fits all solution. That's just not my nature. I don't think that's good medicine. dealing with Epstein Barr and other chronic latent infections has to be done in the context of. The individual person, the whole body, as well as using a systems-based approach. So there's no universal Epstein Barr protocol that's going to work for everybody. I hate to tell you that it's just doesn't work that way. And sometimes dealing with a viral burden first is the best first thing to do. But in most cases, other things have to be in place before we can do that successfully. And what works for one person's latent EBV. or other viruses going to crash somebody else. if you've been listening to me long enough, I hope you understand and really, really, truly understand there is no one size fits all. And the really truly high-level functional medicine is not based on canned protocols, but it's based on a personalized journey that personalizes and prioritizes your plans for your diagnostics for your diet and your lifestyle, as well as supplementation recommendations. So let me let me just kind of summarize here and clue up. Like stealth viruses like Epstein Bar and others, they're the real deal. And they in in many cases, they're the linchpin in any any given particular case. Like you're not going to progress and get better past a certain point unless you deal with it. But we're in a scenario where what has been Counted as the only way to diagnose active clinical problems is really useful only in two scenarios. And again, that's the initial acute infection, or when the virus has come out of latency two into latency three and is actively replicating, which will create a certain appearance of the Epstein-Barr virus panel on your labs. There are many labs that are inconclusive, but the clinical scenario really suggests that there's A viral load that's running a latency two program. Maybe at some point we'll be able to figure out a way to test for those things. But right now we have to base that on clinical judgment and some kind of sometimes just clinical intuition. So if you feel like you are stuck and you're not progressing and you've done what you think you should be doing, or maybe you've already worked with someone in the functional medicine world. And you've only gotten so far. And they've told you, no, you don't have the Epstein bar, you don't have herpes simplex, you don't have human herpes virus six or Coxacky virus or adenovirus or cytomegalovirus or any of these things that display some kind of either latency programs or tissue persistence and immune evasion, then maybe it's time to start to focus on that. And I'm not saying every one of you are going to find like that's not the pot at the end of the rainbow for everybody, but for some of you it is. Right. And so you need to take that seriously. So I don't know. Sometimes it's time for a grounded serious reality check. And I try my best to not speak ill of other practitioners, but it's hard to stay quiet when you see large segments of the functional medicine community or natural medicine community really kind of missing the boat. And I think this is one of those key areas. So You know, I want you to sp stop spending so much time and money looking for magic bullets or, you know, using advanced longevity shortcuts and complex biohacking protocols and random online herbal protocols when your foundation is frozen in a state of some kind of negative metabolic or immunological reprogramming. And I'll again beating a dead horse, but you can't outhack a broken and fractured physiology and sometimes the viral load. Is part of that. Crafting wellness is not the same thing as managing a disease or using biohacking short scut your shortcuts. It requires finding your unique root causes, or I should say root cause disruptors, building metabolic resilience, and moving step by step through a real journey. That focuses specifically on certain things at certain times in that process. And, you know, when when clients work with me directly one on one, I'm the one who dives deep into your medical history. I'm the one who reviews all of your functional diagnostics. I'm the one who walks with you through every single phase of your journey. And since I don't have any staff, I'm the one who responds to all of my requests and texts and emails personally. And if you're ready to stop majoring in the minors, to focus on the things that are really true important before you do the fine-tuning stuff, if you're really ready to finally fix the root causes that are driving your chronic symptomatology, you can reach out to me anytime. Like, don't don't wait for next year or next month to reset your health. Like, look, you can look in the episode description right now. You'll find my direct number, my email, a link to my secure online web request form where you can request a a text back from me or a consultation to get scheduled and fill that out and we'll see if it makes sense to set up a one-on-one Zoom call and we'll figure out exactly what your personal journey looks like and how we can get you back to a state of vitality. Well that's it for today. Thanks guys for listening to me right here on the Inflammation Nation. Stay safe and we'll talk to you soon.