In this interview I discuss the connection between infections and autoimmune disease which I call the Infection Connection.
That being said, let's get on with it. Let me introduce our speaker for tonight. Dr. Nikolas Hedberg is a good friend of mine. I've known Nik for, I think somewhere around 10 years now, we both went to one of the same schools in our careers, not at the same time, but we, I guess, met at a, I think, an internal disorder conference in New Orleans, I think was the first time about 10 years ago. I've followed Nik's work and his career and he's done some outstanding work. Nik is a board certified Chiropractic Internist by the American Board of Chiropractic Internists, he received his bachelor training in Exercise Science from the University of Florida, received his Doctor of Chiropractic from the Texas Chiropractic College in Houston. He currently practices in Asheville, North Carolina and focuses on Lyme disease, thyroid disorders and autoimmune disease. He's the author of the book "The Complete Thyroid Health and Diet Guide", which is a comprehensive guide to diagnosing and treating thyroid disorders. He lectures at a lot of integrated medicine conferences, and he's published in a lot of journals. He teaches Functional Medicine concepts through many forms including Functional Medicine Town, Professional Co-op, and with Hawthorn University. His particular interests lately is the role of stealth infections in chronic disease and in that effort to get this message out, he's created a program called "The Infection Connection" and does some online training in these concepts, and he'll tell you more about that as the night goes on. Little known to everyone in the professional world but known to me, Nik is an accomplished opera singer actually, so you'll hear that when you hear him talk, you can hear that come through in his voice. Anyway, Nik thank you for being on. I know you've been on Clinical Rounds before and thanks for coming back and being a guest again.
Nikolas: Thanks for having me on David, it's good to be here.
David: Great. I mean this is a fascinating topic and a topic that's been really been, sort of, obsessing me for the last couple years. As you can see by the content or the topic of our Core III seminar. I've recently written pretty extensive articles on these concepts in Townsend Letter and Naturopathic Doctor News and Review and in other forms. I'm really interested and jazzed about tonight's call and interviewing you because I hope to learn more about this as well because it's literally emerging science day by day. I think it would be a full time job just to keep adequate surveillance of the literature on just what we're going to talk about tonight and stay current with it. Anyway, I know that I kind of started having to really school myself on this stuff out of sheer necessity by virtue of my patient population and how it's changed over the years. I guess we'll talk about that a little bit more but I wanted to really learn a little bit more how you got started in managing patients with chronic infections or stealth infections and how you found your way into really almost sub-specializing in this area of functional and integrated medicine.
Nikolas: Right, it was actually about eight or nine years ago that I was actually listening to you, David talk about the connection between [inaudible 00:08:55] and autoimmune thyroid disease, and ever since then this has really been an interest of mine. I knew it was something that I need to learn a lot about, started seeing more and more patients with Hashimoto's, and chronic fatigue and various autoimmune diseases. You start doing all the things you know in functional medicine, sealing the gut, vitamin D, you know etc. etc., and you can do all that but there's that group of patients, that population that they just don't respond to those things and I found with a lot of those patients when you dig a little bit deeper, a lot of times you'll find an underlying infection that's been overlooked.
You know, I saw my first Lyme patient back then and didn't really know how to treat it. Sent the patient out for treatment, you know, heavy doses of antibiotics, to an integrated medical doctor, and the patient came back about nine months later and she was just worse off than she was going in, she couldn't handle the treatments. Started seeing some more Lyme patients after that and realized that I had to learn to treat that as well, you know, from a functional medicine perspective, The way I think about it is a lot of times it's not that there are more infections out there, obviously there's more Lyme infections, but a lot of us have these infections in us and it's the consequences of our modern day lifestyles, high stress, poor diets, environmental toxins, things like that and our immune systems just can't keep up with it. Then the infections that we have either emerge, because they are opportunist infections, or we're not just able to fight them off. That's how I got started in treating these types of disorders.
David: That's interesting because, you know, it is food for thought. I often wonder, are these infections more prevalent, are we just better at finding them, are we more aware of them since people have started talking about them and connecting the dots with the associations between certain infections and certain chronic pathologies? Is it, like you just said, you know just another straw on the camel's back, and the back is so ladened with different stresses and pressures in modern patients that the infections that otherwise wouldn't really cause much of a problem in a stronger individual become clinically significant? I don't know what the right answers are but I can tell you one thing, I've been practicing now for 21 years and I think, personally, I think patients are getting sicker in many more complicated ways.
I've sat back and tried to analyze that too, it's just because compared to 20 years ago even 10 years ago, I get probably more complicated patients because almost virtually my entire patient base is referrals from other practitioners and a lot of it is from other integrated and functional practitioners and I tend to get sent, I think, the worst of the worst or the complicated ones, the ones that just don't respond and don't get better. Maybe my patient cohort is skewed but overall I just think patients are more complicated in their illnesses and whole systems biology are wed, if you will, or swirling around their presentation is more complex.
I wonder, you know I practice in Connecticut too so it's even more complicated because the whole Lyme and co-infection thing is so prevalent here and it's so hard to really treat this stuff and it's hard to test adequately for it, it's hard to treat it adequately, it's hard to know you have it. How much is that in play that we're just not aware of? You mentioned fixing the gut and vitamin D and all the normal functional medicine kind of approaches that used to work almost miraculously with the majority of chronically ill patients, I find that it works with a smaller and smaller percentage of my patients, we've got to go digging into other very complicated stuff. Do you see that same phenomena, do you have any feelings on that?
Nikolas: Definitely see the same phenomenon. Doing all the functional medicine things that we should be doing, patients aren't getting better, and they're coming in with just all kinds of, they're almost things that you can't even label. So-called mystery illnesses, chronic fatigue, fibromyalgia, all the different autoimmune diseases, and then in some cases there's nothing really showing up, even on a comprehensive blood chemistry. I mean there is nothing there but they're still sick. When we scratch a little bit deeper, you know, a lot of times you do find infections and a lot of these infections will mimic those conditions that I was just talking about. Where conventional medicine says, well, you know, we don't really know the cause of chronic fatigue syndrome or autoimmune disease, it's just a consequence of the relationship between genetics and our environment. There's also not a lot of profits to be made in long term antibiotic use and that could be another reason why it's not as looked at as heavily as it should be. Speaking in regards to the connection between infections and somebody's chronic illnesses.
David: It's also amazing in the history when you do an intake on a patient fact, honest injun, it happened twice today. I had three new patients today in my patient load, two of them had the onset of these kind of chronic things as they tell the story. The onset was immediately after they had a significant, like, kind of viral infection that came out of nowhere like an upper respiratory type of infection that just didn't want to go away and since then they'd never quite been right. That whole connection between a viral insult then it became a chronic smoldering thing. It's been something that's been known in chronic fatigue circles for a long time with CFIDS or Chronic Fatigue and Immune Deficiency Syndrome and people who looked at lymphocyte sub-sets forever, but I think maybe that phenomena is much more broad based than just in that one. How do you go about identifying infections, particularly stealth infections, clinically or in a laboratory?
Nikolas: Of course you start with a comprehensive history, like you just said, I'm finding that as well someone will have a really bad cold or flu or GI infection, tick bite you know etc., etc., and they just never were able to recover. That's a good indicator in the patient's history and of course where they live, history of tick bites, and some of these patients will come in and will have just a fever of unknown origin and there's really no signs of cancer so just a basic fever that's an infection, until proven otherwise, and a lot of them will say,
