Hey Lyme Disease, Meet Leptin!

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Readers Summary

  1. Why is lyme misunderstood
  2. Is lyme connected to fibromyaliga, mold, and chronic fatigue syndrome?
  3. How do we test for it and how might we treat it?
  4. How does leptin tie into this story?

I do not believe there is a more misunderstood disease by conventional medicine than Lyme disease and Fibromyalgia. Many healthcare providers do not even think FM exists to the determent of millions of people. It is estimated that ten million people suffer from these diseases today. 75% of them are women. The reason for that is because leptin is involved, and as you all know it is a sexually dimorphic hormone. These are diseases that affect the fat cells in all parts of our body. They also cause issues with adiponectin, which is also sexually dimorphic. Many women will be glad to know that fact. Understanding Lyme disease actually helps you understand FM very well.

Both diseases cause abnormal activation of an immune mediated pathway that takes over cytokine production in the fat cells that line our GI tracts, respiratory tracts, sinuses, and many other organs. Most know that Lyme is most commonly associated with a tick bite, and the host gets infected with spirochete bacteria. What most do not know, is that this tick liberates a neurotoxin that causes most of its symptoms. This neurotoxin activation is common to many diseases just like Lyme disease. FM, Chronic Fatigue Syndrome, Sick building Syndrome, and mold exposure are just a few. All these diseases activate the same pathway, and this is why they have features that are quite similar clinical findings. Making these connections clinically helped me tie this all together. Since I came to a deep understanding of how important leptin is to our body several years ago, it made complete sense to me to think all these diseases might have a leptin link because of the constellation of symptoms were all tied to specific cytokine activation. This is precisely how leptin resistance develops too. This is how a change of perspective might help a physician see a problem in a new way. It is precisely how Evolutionary medicine prism has allowed me to come to bio-hack just about any disease we face as a species now.

For example, fibromyalgia has a massive influx of inflammation from the GI tract or respiratory system that causes severe leptin and circadian dysfunction due to neurotoxin and can be measured by Visual Contrast Sensitivity biomarker test. These small neurotoxins are stored in fat cells, and when they are released from the fat, the toxins end up circulating through the fat-containing tissues of the body to cause their havoc.

These new toxin-producers include the following:

  • dinoflagellates, such as Pfiesteria, ciguatera and chattonella;
  • fungi, including stachybotrys and fusarium;
  • bacteria, such as pseudomonas fluorescens;
  • spirochetes, including Lyme disease-causing borrelia;
  • blue-green algae, such as rapidly reproducing microcystis and cylindrospermopsis.

This is what causes these diseases: Biotoxins, not crazy ladies!

It seems that conventional medicine has not stayed up with the published literature. Few people seem to know this information. Moreover, FM is most certainly a real disease. It is not well studied, and the treatments for it quite different than one would conventionally expect. The reason for this is because medicine today has a rudimentary understanding of how inflammation and the brain connect together. The bridging principle that ties these concepts together is leptin once again.

Specific protocol for Fibromyalgia/Lyme disease/Chronic Fatigue patients:

Perform the Contrast Sensitivity Test first. This test functionally creates a binary output system by assessing the nerve-function of contrast in part of the optic nerve. The assessment provides an accurate model for the overall effect of neurotoxins on the patient’s system. It evaluates two sets of nerves in the eye that allow one to differentiate between white, black, and gray, on a gray background. It has been found that a subject with biotoxin-associated illness will demonstrate a deficit on this non-invasive neurological evaluation in that they will not be able to identify the direction of various patterns presented. Failure to successfully complete this test is a strong indicator of a biotoxin illness! Though it is possible for a person impacted by biotoxins to pass the test (a false negative result), this occurs only in about 8% of test subjects. Thus, the VCS test supports diagnosis in about 92% of affected people. False positives are quite rare.

There are specific genotypes associated with specific susceptibility to biotoxins. For patients with Lyme disease or mold exposure, approximately 25% of the population has a genetic predisposition in coming down with these diseases which results in an inability to clear biotoxins naturally. This is due to a defect on the Human Leukocyte Antigen (HLA DR) gene set on chromosome 6. The genetic test is called HLA DR, and it is commonly known as a test which provides insight into possible organ rejection after a transplant operation. One can then use an interpretation guide written by the protocol’s founder, Dr. Shoemaker, which maps the HLA DR combination findings to specific conditions which may be associated with multiple biotoxins diseases. The biotoxin can bind to Toll receptors in the gut or in fat-cells and cells that line blood vessels, resulting in the productional array of cytokines which are involved in immune response and inflammatory processes. MMP9 is a superb marker for the presence of excess cytokines production from any inflammatory disease. I often recommend people consider getting in cases that seem unsolvable. It is a great detective test for one to use in any undiagnosed inflammatory condition.

MMP9 appears to be responsible for delivering inflammatory compounds out of the blood and into the brain, which causes plaque formations similar to those seen in MS too. Most MS patients will have extremely high levels of MMP9 in their serum and tissues. In Lyme disease, MMP9 levels may skyrocket as the result of treatment with antibiotics, and the resulting bacterial die-off in what is commonly referred to as a Herxheimer reaction. During this reaction, the symptoms usually get more severe. They often can be mitigated by using cholestyramine (CSM) to bind the biotoxins that are circulating in the fat. If you are dealing with Lyme disease only based on the HLA DR array, you must first kill the spirochete and then go after the neurotoxins. If you give a Lyme-infected person antibiotics and they are not HLA-susceptible, they generally have an uneventful recovery. Not everyone falls into this situation. Lyme disease treatment can be followed with a simple blood test called a CD57+ white blood cell test. Two physicians found that CD57+ T Cells are lowered in Lyme disease progression. When Drs. Stricker and Winger discovered that CD57+ NK cells were low in chronic Lyme disease sufferers, we had a test to follow patients’ clinical improvement or decline. This gave us an opportunity for infectious disease practitioners to utilize a simple blood test in the diagnosis of chronic Lyme disease. Since we can now follow treatment progress,s it also clearly helps us determine treatment endpoints as well. Just as HIV patients have used their CD4 T-cell count, Lyme patients now have a fairly reliable marker of the status of their illness.

What about the common pathway of all these diseases?

An increase in cytokines release (IL-8) may also trigger auto-immunity if the process is chronic. IL-8 is a cytokine amplifier for our immune system. There are three key types of antibodies observed in those with biotoxin-associated illnesses. These are myelin antibodies (the protective sheath around nerve cells), gliadin antibodies (a protein found in gluten), and cardiolipin antibodies which impact circulation in the arterioles of the vascular trees in our bodies.

There may be notable increases in markers which reflect activation of the complement system, namely in C3a and C4a. There is a significant difference in C3a and C4a levels between controls and the Lyme or mold population. In fact, C4a levels invariably become elevated, often as early as twelve hours after a tick bite. In the case of those with a mold-susceptible HLA type, C4a significantly increases within four hours after re-exposure to a moldy environment. C4a can be a helpful marker in determining whether or not a remediated home is still a danger for someone with mold biotoxin susceptibility. If C4a levels have been reduced via appropriate interventions and C4a levels rise upon reintroduction to the suspect environment, it is a sure sign that the environment is not safe for the patient. You can also run a home air quality inspection for about 1000 dollars to back up the testing. Sometimes the exposure is in a car or at work. This can be a messy situation if it occurs diagnositically

A word about CD57+ testing: If you would like your health care provider to order the CD57 NK test for you, your blood sample needs to be drawn into an EDTA tube (lavender top) on Monday through Thursday and sent immediately to either LabCorp in Burlington, NC, or Clinical Pathology Laboratories (CPL) in Austin, TX. LabCorp and CPL are the only two labs that perform this test properly. Quest does NOT. The LabCorp test code is #505026 and is named HNK1 (CD57) Panel. The CPL test code is #4886, CD57 for Lyme disease. The test is time-sensitive, and must be performed within 12 hours of collection, so blood should not be drawn on a Friday or results may be inaccurate.

Where does leptin enter the picture on these diseases?

When biotoxins from any source cause amplification of cytokines, they chronically elevate serum leptin levels. Remember from my leptin series, I told you that leptin is chemically similar to IL-6. LR also occurs because of inflammation in the gut that penetrates the brain and deactivates the leptin receptor. The same thing happens in these diseases we are talking about today. This is a great example of a new brain gut axis disease that medicine just has not put together yet. The biochemical connections however are paramount in understanding how these all weave together. When leptin increases as the result of a biotoxin exposure, there is a simultaneous decrease in alpha MSH secretion from the hypothalamus (alpha melanocyte stimulating hormone). When leptin increases and alpha MSH decreases simultaneously we can completely explain their clinical symptoms. These patients become naturally heavier with all these disease and commonly become very resistant to any weight loss techniques that do not link to repairing leptin receptor functioning.

Lowered alpha MSH is the key common finding in all these biotoxin diseases. It controls the biotoxin pathway as its major anti inflammatory compound. Lyme disease, chronic fatigue syndrome, FM, mold illness, and any other biotoxin illness regardless of the source of the biotoxin, we find reduction in MSH in 95-98% of patients!

When MSH levels are low, people also become sleep disturbed because of damage to the hypocretin neurons that modulate sleep. We can test for this by seeing lowered DHEA levels and elevated IL-6 levels. They all tend to have chronic pain, and this is due to the blockade of the endorphins pathways by the lowered levels of alpha MSH. We have known about the effect of alpha MSH on pain for sometime in anesthesia literature, but this is usually modulated via excessive omega six components in our diet that drive series two prostaglandins to cause chronic pain development. This is a reason why many more pain specialists and pain patients should consider sampling alpha MSH levels to help their patients who suffer from chronic pain of any source. It is also why many patients I have treated with the Leptin Rx have gotten major pain relief before they had to have any spine surgery! A big finding in these patients is they all experience some version of the “leaky gut syndrome”. Too bad allopathic medicine does not recognize this symptom. Maybe this underlies why they have never solved the mystery of these diseases too! This happens because of the massive release of cytokines through the amplification properties of IL-8 in the gut mucosa. Often, their recovery from any illness is usually delayed, and they seem to be chronically sick or suffering from long lasting adrenal fatigue symptoms. There is a major neurologic reason for this. Reduced levels of alpha MSH are initially correlated to elevations of cortisol and ACTH but as the toxins are allowed to amplify, the immune response responds by making more cytokines, and eventually there is a dramatic reduction of production of pituitary levels of ACTH and cortisol. This cause people to have very low levels of cortisol in 24 hour collections, and we generally see major changes to the normal circadian cycle of cortisol on salivary samplings. Many people with chronic adrenal fatigue actually suffer from this problem and never realize it. Very few physicians have made these connections because they do not understand the importance of leptin and inflammatory brain diseases. Obesity, FM, Lyme Disease, and mold intoxications are all very similar symptoms of the same disease processes. When I hear a patient has chronic symptoms that do not respond to classic my classic leaky gut Rx, I begin to think I am dealing with Lyme disease, FM or another chronic neuro toxin linked disease that is still uncategorized. Another clue for the surgeon in me is that these patients tend to develop multiple antibiotic resistant coagulase negative staph colonization (MARCoNS). We see this in the hospital when they come in for surgery, and we are told that our patient’s nasal swabs are MRSA positive. This is a major clue to the surgeon or physician that something else maybe cooking than the standard diseases we see with a leaky gut.

These patients also have frequent thirst, and they usually are tested for diabetes because of this symptoms prominence. This is another neurologic manifestation, due to lowered secretion of the posterior pituitary hormone called, anti-diuretic hormone (ADH). Patients tend to show higher levels of sodium on their chem 20 testing, and they also have a higher serum osmolarity if it is test. Often it is not, because this disease is a very deep bio hack that most physicians do not learn in training. Many patients will complain of a tremendous loss in libido due to a lowering of all the sex hormones and the precursor hormone DHEA. This symptom is worse in women than men, because women have higher leptin levels and are far more sensitive to changes in its normal physiology by the lowered alpha MSH levels. Alpha MSH is a major modulator of leptin function. All these can be found with testing, if one knows what you are seeing clinically. People with low alpha MSH levels also are very sensitive to the sun, because they can’t generate melanin production in their skin. They tend to be fair skinned. I have long thought this was the mechanism of how vitiligo begins. If you amplify the cytokine signal long enough, it will totally destroy your ability to replenish melanocytes and your skin will bleach. It also plays a role in physiology. I think this is where alopecia areata, alopecia universalis, and other autoimmune diseases of the skin and hair come from.

MSH is intricately involved in the production of melatonin and endorphins in the brain. This is where my neurosurgery training really tied a lot of the pathophysiology together. Alpha MSH is cleaved off the larger POMC protein that is made in the brain. This quotient of the cleaving causes a lack of circulating endorphins in our CSF fluid, and this increases our perception of pain in all parts of our body. This is why Lyme and fibromyalgia patients have so many muscle aches and pains. Everything has a biochemical reason when you follow medicine from an evolutionary prism. This is a huge benefit to thinking about diseases in a new way. MSH also regulates the protective cytokine responses in the serum of our blood, skin, digestive tract, and respiratory membranes. Lowered MSH in these areas also results in abnormalities in production of cortisol and fluctuations in ACTH (adrenocorticotropic hormone) which regulates adrenal function. People with chronic adrenal fatigue often have biotoxin disease and rarely know it. One way to assess it is to get their alpha MSH levels tested at the same time as their C4a levels!


  1. If you are dealing with Lyme, it must be treated with 3 weeks of antibiotics to kill the spirochete bacteria and then try to clear the biotoxins. When this bacteria is killed, expect a serious Herxheimer reaction and your symptoms to get worse before they get better. There is a treatment option for this, however, to mitigate this biochemcal process.
  2. Cholestyramine (CSM) is a resin which has been historically used for lowering cholesterol levels. It is very effective in clearing the remnant biotoxins as well. It is very cheap to use as well. It has a positive charge that binds to a wide range of different low molecular weight, negatively charged toxins and helps to shuttle them out of the body through the digestive tract. It is also not systemically absorbed, so it is pretty safe for most people. CSM use usually leads to a dramatic fall in C4a, and if it comes back quickly, you must assume the Lyme is not killed or the mold/toxin is still present in your body or the environment.
  3. Treatment for biotoxins may utilize targeted gene therapy using Actos. Actos is a dirty word for most diabetics following a primal template, but in these diseases it may be a life saver. Actos is a drug approved for the treatment of diabetes that has recently become black boxed, because of an increase in bladder cancer when it is used over a year. It was banned in Europe for this reason recently. For this indication, it is not used that long. This drug limits the effects of the Herxheimer reaction that occurs in killing off the bacteria’s associated with this disease set. It has a significant number of benefits for those with biotoxin-associated illness. Actos lowers leptin, lowers MMP9, raises Vascular Endothelial Growth Factor, and positively PPAR-gamma all while improving insulin resistance and lowering system inflammation by slowing cytokine amplifications that occur in these diseases. It is one of the most important interventions known in treating biotoxin illnesses, because it seems to block the cytokine storm or Herxheimer reaction that occurs in 50% of Lyme patients. The interesting thing is that Actos will not work if you eat a SAD, or high carbohydrate diet, because of leptin effects on NPY in the hypothalamus. It works best if one eats a ketogenic paleolithic diet.

I hope you found this interesting. It is another piece in the Quilt that shows you that everything is connected at some level, and that we should to continue to solve the puzzles of diseases that allopathic medicine just does not understand by using an evolutionary biologic prism to see these diseases. I put many of these links together over the last 7 years after I came to realize the importance of leptin to human biology. There is not one disease we can’t solve if we think about the disease using what evolution has taught us.

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  1. Resurgent says:

    Dr Kruse,

    The Bio-toxin chart at the end is a very welcome addition – made the article a whole lot easier to understand. Thanks.!

    • @Resurg I figured it would be because this is complex neurologic anatomy but once you see how this all works you begin to see just how incredibly important leptin and inflammation cascades are in every neolithic disease we see. The major conduit of inflammation is from the gut too……..

  2. Is there any test to determine if in fact a person has ever been infected with Lyme disease? I ask because years ago I had a tick bite which developed a bullseye mark on my stomach but was not seen by a doctor. I subsequently had a few major doses of antibiotics for

    re-occurring bladder infections which probably cleared up the tick reaction. I've always wondered about it.

    • @Anna CD57+ testing is a testing to see if you are chronically infected. There are no acute tests that are accurate infection and this is why so many conventional physicians are perplexed by it. It is the one infection that is not really blood born……it makes its way to the fat and lymphatic system and avoids our immune system. Once there is IL-8 amplification it overwhelms the hypothalamus and causes the chronic fatigue systems by lowered alpha MSH in the hypothalamus. It can even cause acute onset T2D due to high MMP9 amplification cause severe acute leptin resistance.

  3. Heather B. says:

    Anna, if you had a bullseye rash (anywhere, not just at the site, actually), then you had/have Lyme. If you have continuing health issues that ring true for Lyme, I would pursue testing and/or treatment with a Lyme literate physician (LLMD). It's possible the abx you were on previously affected it, but it has been believed by many that a short (i.e., 1 month or less) course of abx is insufficient to completely eliminate the Borrelia bacteria, which change their form at various times in their lifecycle. They will not be susceptible to abx at all points in the cycle and therefore are very hard to fully eradicate.

  4. Jack-

    Lyme disease is endemic to the eastern part of New York State, where I live. I see a lot of it. Is the neurotoxin stored in the fat cells? How long should it someone eating a (unfortunately) SAD diet to clear it?

    • @Dr. Sorrentino It will clear from the fat if the patient does not have the HLA DR issue. Our bodies slowly will clear it but it stays in fat and fat turns over slowly. This is why so many people who have Fibromyalgia never really know what the issue it. Generally if it is Lyme…..you need three weeks of antibiotics to kill the spirochete……once the bug is killed it liberates the neurotoxin into the system and it causes huge issues. The fatter one is the worse the reaction…….the Actos is what makes it get out of the fat faster and then the CSM is the resin that binds it all up as it is liberated and gets rid of it via the gallbladder. If you do not have a gallbladder clearance is slower………But it will all go. If you done have the HLA DR issue you will slowly clear it over time and rid yourself of it. If it is caused by one of the other organism list in the blog or by mold you need to use the Actos and CSM to help FM or Mold patients while supporting their hormone levels that are destroyed by the toxin. This is how some people can gain 100 lbs in a yr after chronic fatigue. Physicians do not realize this is an aggressive form of obesity due to amplification of the cytokines of our immune systems going after our hypothalamus…….This is why I told Jimmy Moore on the January 6, 2012 podcast that obesity is an inflammatory brain condition. So is lyme, Fibromyalgia and mold diseases……..

  5. @ Jane here is the Lyme work up that is copied from MDA thread to address your question you emailed.

    LAB TESTS for Dr. Stricker

    Tests that may be performed before the first visit


    The following tests MUST be performed at IGeneX Laboratories.

    No other lab is acceptable. Please call them at 1-800-832-3200

    and ask for a "blood test kit" which they will mail to you.

    Everything you need will be with the kit.

    Check off all of the tests below and then take it with you to your

    health care provider's office for him to sign and complete the provider's information.

    These tests must be paid for upfront by check or credit card and can later be

    submitted to your insurance under "out of network" costs.

    The tests should be drawn on Mon, Tues or Wed.

    Medicare Patients. If you have Medicare Insurance that is NOT operated by an HMO,

    then check off the following tests on the requisition form:

    Test #6050 ——– Complete Lyme Panel

    Tests # 200 , 663 and 720 ——– Babesia tests

    Tests # 285 and 280 ——– Bartonella tests

    Test # 770 ——– HME PCR

    Tests # 206 and 775 ——– Anaplasma

    Tests #965 and 998 ——– Rickettsia

    Non-Medicare patients or those whose MC is operated by an HMO, order the following tests:

    Test # 4090 ——– Basic Lyme Panel

    Test # 200 and 720 ——– Babesias

    Test # 285 ——– Bartonella

    TEST # 203 ——– Ehrlichia

    Test # 206 ——– Anaplasma

    For all the IGeneX tests you can use the ICD9 code of 088.81


    (Most health care providers have LabCorp requisition slips. Do NOT do this test at Quest!!)

    Test # 505026 ——– HNK1 (CD57) Panel ——– Use ICD9 code 088.81

    This is a "write-in test"that won't be on the requisition form

    This is a very time-sensitive test. Please make sure they overnight it.


    (These must be done no more than 6 weeks before the first appointment)


    TSH and Free T4




  6. Dr. Tim Jackson, DPT says:

    Thanks for posting this, Dr. Kruse. I tested positive for Lyme on the Neuroscience Immune tolerance test. The Lyme can come from MANY avenues other than ticks–mosquitoes, etc. I learned this from D. Klinghart and S. Sponaugle. What do you recommend doing for the gut if the alpha-MSH doesn't rise?

    • @Tim There are MSH replacement but none that I know of get into the brain totally. I think one must drive their highly sensitive CRP to zero while supporting hormone response with bioidentical support and using CSM and Actos in a responsible fashion if you have the HLA DR status present. The best way is cold thermogenesis in my view but few do it.

  7. Yet again Dr K you've knocked it out of the park! And another piece of my puzzle falls into place. I was dx w/FM by the VA when I was living in a house that ended up being condemned due to stachbotrys! 1 year later I was living in another house – I woke up to go to work, hopped into the shower and suddenly felt like I was burning from the inside out (like I'd been exposed to a chemical weapon), I was shaking from the intense pain from the burning, and anything touching my skin was extremely painful. I had a friend take me to the VA – and I saw an intern who told me I was just having a bad FM day. I walked out and went up to see my neurologist w/o an appointment. fortunately for me the nurses in neurology knew I wasn't well – and sent me straight into see the doc. His initial reaction was it was 1 of 2 things. 1) a reaction to the migraine/bipolar/FM drugs I was on – and he instructed me to stop taking all of the meds – and placed a comment in my chart that I couldn't be treated for those conditions using those drugs, his 2nd opinion) was I was having a delayed adverse reaction to a vaccine, for which I had received the first 2 doses of 6, but stopped series b/c of a sever rash after the 2nd dose. I'm wondering if what I experienced was some sort of Herxheimer reaction. At this appointment was when my Neurologist sent me to my chriopractor/NP. He set me on a gf/casien free diet. It took me 6yrs to find the primal way of life, and my health has never been better, especially since I completed the Leptin Rx. I have no idea if this has fully resolved – though considering I continue to have thrush related issues while nursing – I still have more work to do. But that's ok. I'll keep peeling back the onion layers until I'm Optimal.

  8. Hey Doc, can you fix the tag after the scientific names in the New Toxin Producers

    please and then delete this comment. The italics are hard to read on my IPad and impossible on our nook.

  9. Does malaria work the same way with biotoxins? My husband got it in Vietnam. He had recurrences for 15 years, but has been free of it since then. And his father had a recurrence of it 25 years after getting it in WWII.

  10. From JAnsz via MDA


    Melanocyte-stimulating Hormone (MSH)


    Alpha-Melanocyte-stimulating Hormone


    αMSH Melanocyte-stimulating Hormone (MSH), Plasma



    Complement C4a


    Complement C4a des-Arginine

    Test Number: 004330 CPT Code: 86160

    Specimen: Plasma (EDTA) with Futhan, frozen

    Volume: 1 mL

    Use: Activation of the complement system plays an important role in our natural ability to ward off infection and in the pathogenesis of infection and inflammation.1-6 Anaphylatoxins produced as the result of complement activation play a role in a number of infectious and inflammatory conditions including sepsis, ischemia-reperfusion injury, immune complex diseases, and hypersensitivity diseases like asthma.1 Anaphylatoxins are also thought to be important in the pathogenesis of allergy, autoimmunity, neurodegenerative diseases, and cancer.2,3

    Complement activation can occur through three separate mechanisms. The first mechanism to be discovered, referred to as the classical complement cascade, is activated by antigen-antibody complexes.4-6 This was the basis for the name of this system as they serve to "complement" humoral immunity. Alternatively, the complement cascade can be activated directly by contact with bacterial cell surface molecules, including lipopolysaccharide from gram-negative outer membranes, teichoic acid from gram-positive cell walls, zymosan from fungal and yeast cell walls, and some parasite surface molecules. Recently, a third activation mechanism has been characterized in which mannose-binding lectin synthesized by the liver in response to inflammatory macrophage cytokines stimulates the activation of complement.

    Complement cascade activation results in the formation of complement split products C3a, C4a, and C5a.4 These proteins, referred to as anaphylatoxins, facilitate the phagocytosis of immune complexes, viral particles, toxic cell debris and apoptotic corpses. Anaphylatoxins promote an inflammatory response by binding to complement receptors on granulocytes and macrophages.2 Anaphylatoxins also bind to receptors on mast cells, which trigger the release of histamine, increasing blood vessel permeability and smooth muscle contraction.6 They control the local inflammatory response through activation of leukocytes and stimulating their chemotaxis to the site of infection.4

    Complement C4a levels can become increased in any condition associated with inflammation.2,3 Normal human pregnancy is associated with evidence of complement activation, with an increase in concentrations of the anaphylatoxins C3a, C4a, and C5a in the maternal circulation.7 Levels of anaphylatoxins C3a and C4a have also been found to be elevated in patients with antiphospholipid syndrome relative to healthy controls.8 Ingram and associates have shown that levels of C4a are increased in patients with multiple sclerosis, especially during relapse.9

    Complement activation split products are present only in trace amounts in normal plasma in vivo.10 It is crucial that samples be collected and stored properly in order to avoid in vitro activation.10 Blood must be drawn directly into tubes containing EDTA at a final concentration of at least 10 mM.10 Citrate and heparin do not block complement activation efficiently and should not be used.10 The addition of nafamostat mesilate (Futhan, FUT-175) further reduces in vitro complement activation.11

    Limitations: Results for this test are for research purposes only by the assay's manufacturer. The performance characteristics of this product have not been established. Results should not be used as a diagnostic procedure without confirmation of the diagnosis by another medically established diagnostic product or procedure.

    Elevation of C4a levels is not predictive of any specific disease.1-9 Complement C4a levels can become increased in any condition associated with inflammation.2,3

    Samples that are not properly collected and stored will produce erroneously elevated results due to in vitro activation.10 Blood must be drawn directly into tubes containing EDTA at a final concentration of at least 10 mM with the addition of nafamostat mesilate (Futhan, FUT-1750) to further reduce in vitro complement activation.11

  11. Hey Jack, great article. Do you have a higher res version of the biotoxin chart at all please? It's a little hard to read some of the text. Thanks! Keep up the good work. Best, Pat

  12. Souldanzer says:

    Hi Dr. Kruse,

    thank you so much for all the education and support you provide so freely. I'm working on healing from a 20+ year severe illness that has left my body and soul broken and am deeply grateful to have found this wealth of information on how to help myself (and my medical team!).

    Off topic question:

    If one gets peri-oral & peri-ocular dermatitis from use of coconut oil as a moisturizer, should coconut oil be entirely eliminated or is it enough to just stop using it on the affected areas? Does having a localized allergic reaction automatically mean that one is systemically intolerant to the product?

    Coconut products have become a very important part of my diet. Due to multiple food sensitivities, I'm starting to run out of ideas of what to eat and cook with.

  13. What a treat to wake up this foggy morn (I'm only 150 miles from you), brew some jasmine green tea, go to my fav website… and find an article on my world!!!

    I may have Lyme's, but then again, maybe not. All I know is something kicked my ass three years ago, and, when I did my research, it pointed to a bacterial infection of some kind.

    I was sure Lyme, FM, CF, and depression had to have a pathway that was detectable, and I knew you were the guy with the 30k foot view to bring it to a workable perspective. Thank you!

    You are the cutting edge of changing medicine and I see a time when people will look back and see your work as a major turning point in healthcare.

    My challenge now is to find a healthcare practitioner that is savvy enough to accept a patient who is knowledgeable and willing to listen to me without feeling like I'm stomping on their ego. I have a sizable amount of tests already done – TNF-a, homocysteine, HS CRP, 6/3 omega ratio, VAP, T, RT3/T3, D, B-12, 24 hr. Cortisol, progesterone, Gliadin, CD57+, Western Blot, etc. – but I need guidance to move forward efficiently.

    Trouble is, I'm smarter than the docs I've been to so far!!! We need to start networking to connect patients with docs, practitioners, etc., that are clued into leptin, et al!!!

  14. KathleenM says:

    Wow oh wow!!! I CANNOT wait to take this article to my integrative med doc! We've suspected I had/have lyme but never really pursued it. I used to be an avid hiker and gardener and have had ticks on me more times that I can count. He's more focussed on the celiac, lupus/FM, mold, candida, adrenal exhaustion, etc. I'm going to request I get tested. Like the others before have said, another piece of the puzzle has dropped into place! Thank you Dr. K!!!

  15. Thanks for your post. Some things you mentioned really clicked for me, but I'm still a little confused. You say that Lyme, FM, and mold toxins share similar symptoms from biotoxins in the fat cells. Are you also saying that Lyme is often misdiagnosed as FM/mold issues? Or are these still separate diseases? You also only give a treatment for Lyme. What do you suggest for FM patients? I was diagnosed with FM 15 years ago. I also have severe oxalate issues (I produce it endogenously, but I have also long suspected a leaky gut problem), mold allergies, chronic sinusitis, PCOS, problems with hypoglycemia, and I get sick easily and take forever to heal from viruses(doesn't help that I have germ-sharing 3YO twins). A low oxalate diet has really helped (but not cured) my oxalate symptoms and my FM. I've been Primal for three months (Zone diet for 15 years before that) and that has seemed to cure the last of the hypoglycemia issues. I started your Leptin reset protocol last week. Is there anything else I should be doing? Any other posts I should check out? I'm slowly working my way through them and trying to piece together more of my own health puzzle. Thank you!

    • @Heidi…..the mechanism of action for the pain is all the same…….a cratering alpha MSH causes the pain. The work up must be done by an ID doc who understands this disease and the protocol developed to get rid of the underlying toxin. In Fibromyalgia patients there is a serious leptin problem and it is the hardest biohack to perform on patients because it requires 18-36 months of optimal bio identical hormone treatment and regaining LS with the Leptin Rx is the first step. A low oxalate diet is not the biggie…..a ketogenic paleo diet the is a no amylose diet is the Rx for this disease.

  16. Daniel Han says:

    Hi Dr. Kruse,

    Slightly off-topic but some low-carbers, including myself at times, get hives (urticaria) whenever we lose weight. It seems to stop if we eat more carbs/not lose weight. Do you have any experience with this side effect with either your patients or yourself? I've read that it may have to do with mast cell degranulation upon weight loss. I don't believe its a food allergy because I'm literally doing the Paleo autoimmunity protocol. Thanks a bunch, great to hear from your blog again Dr. K.

    • @Daniel Han I use cold urticaria to test for excessive omega six levels in patients who cant afford the omega6/3 ratio……when people are above a 20-1 ration about 50% will have cold urticaria.

  17. I love the way that you tie everything up in an overall system. It gives you a birds eye view and helps understand our wonderfuyl bodies.

    One question: could hearing los be related to overgrowth of bad gut flora via a continuous low level herxheimer reaction? If so, is there a way to reverse the hearing loss?

    • @Marijke Its possible with a Vitamin K2 deficiency and excess D3. It is a gut issue. Read about K2 in my osteoporosis series. It also mention the gallbladder as the recycler that may interest you

  18. Dr. K,

    thought i would add this website for others who may not understand or know how to interpret labs

    i thought it might be a great resource although there might be a better one out there…

  19. William Trumbower md says:

    Jack This is one of the best posts you have written. This ties together many various disorders. You and Dr. Shoemaker have unique abilities to think outside the box that is confining medicine today.

    • @William……Thank you for the kind words. But, trust me there are a lot more where this comes from. Just wait til you read the book.

  20. Nuttmegs17 says:

    Dr k

    WOW again, fabulous post…I have been reading and re-reading it for a couple of days trying to understand it all….I have a question. Perhaps I don't have low MSH bc:

    "When MSH levels are low, people also become sleep disturbed because of damage to the hypocretin neurons that modulate sleep. We can test for this by seeing lowered DHEA levels and elevated IL-6 levels."

    I have high DHEA – is that a fair estimation – that b/c I have HIGH DHEA, then my MSH is prob not low?

    also – if my only pain seems to occur when Thyroid is being attacked (from Hashi antibodies) or thyroid meds are not right – can I assume the pain isnt tied connected to MSH? I'm thankfully free from joint pain and swelling – my swelling tends to be localized on my belly and face and is more like edema or water retention (and generally when I 'm having a reaction to foods like gluten or again, thyroid issues). This would be great bc I'm seriously hoping I dont have Lyme.

    Truely an article that anyone suffering from one of the many conditions you listed should print off and give to their doctor – I did and will continue to do so.

    • @NutTmegs I wrote it for you. I think it maybe why your adrenal is shot……..I had not planned on hitting FM and Lyme until my book comes out because I have a pretty special chapter on an N-1 I did.

  21. Here is a link to the Visual test if anyone wants to take it online.

  22. Doesn't this blog entry draw heavily from the work of Ritchie Shoemaker, M.D?

  23. I am beginning to think that IL-8 may also be elevated in the presence of a wheat-rich diet when a person has gluten sensitivity. If this is the case, than other cytokines are also duplicated. Under the right conditions, wheat may shift and sit a few steps higher than refined sugars on the dietary toxin ladder?

    I feel for all the folks suffering from these conditions. They are insidious diseases with equally challenging solutions.

    Excellent post! This is profound example of the quilt's practical application.

  24. Coincidentally, an article was just posted on WebMD . (http://www.webmd.com/fibromyalgia/guide/fibromyalgia-the-diet-connection). After you read this blog post, WebMD's treatment of the topic doesn't look very useful.

  25. @Jack,

    talking about hormones… I recently did some blood test and I got testosterone OK, but too high Estrogen.

    ** Testosterone: 9.4 ng/ml

    ** Estrogen (17beta-estradiol ): 56.6 pg/ml

    In addition I have some cherry skin spots on my breast that you mentioned in a post on practical physical examination. I've been asking and researching on some forums and seemingly my best bet is to supplement DIM (or I3C), ZMA and mostly avoid xenoestrogens to decrease estrogen.

    Please, what would be your recommendations?. Before messing up with tricky hormone stuff I would like to have the opinion of a real doctor.

    Thanks a lot. Santiago

    PS: I attach below some of the other results in case that helps.

    Diet: mostly Paleo (version: zero grains, very little starches and some dairy)

    Age: 37

    BF: 14-15% according to my balance. Appearance slim.

    Total Cholesterol: 252

    Trigs: 40

    HDL: 97

    LDL: 147

    VLDL: 8

    Fasting insulin: 3.7

    A1C: 5.4 (!ufff)

    hs CRP: 0.037

    rheumatoid factor: 10.3

    Vitamin B12: 662

  26. PaléoDo says:

    Great post Dr Kruse!

    As a conventionally trained MD, I find it very useful to apply evolutionary/physiologically sound approaches to the diagnosis and treatment of chronic illnesses.

     Through this evolutionary perspective, many unexplained or ignored symptoms eventually make sense. Physical exams and patient history are becoming again so relevant. It is so much more rewarding to diagnose and treat the real causes of a disease than to merely prescribe the latest symptom reliever .

     However, there are quite a lot of hurdles on this path. The first one being where and how to acquire this comprehensive clinical knowledge? You mentioned that it took you a decade or so of intensive reading. Where do you advise doctors to go digging for this science? How can we make sound evaluations of this approach? Is there such a thing as a PaleoWebMD? 

    Can't wait for your book to be printed!

    Thank you again for your amazing work.

    • @Paleodocteur……you will be surprised to know that you already know much of the information required……..but you have not learned how to connect it all. Information is not knowledge and without knowledge we dont get wisdom. 21 centrury medicine is about information collecting in columns……just like the cerebral cortex is wired from layers one to six. What I am going to show you in my blog and book is how to run horizontal to this information to make more connections that make even more sense in treating the diseases we treat. Once you think this way all the time you will be able to tap all that information for new insights and sources of nuggets that you are now not aware of but completely exist.

  27. I am looking for a doctor in the midwest who can treat this? Any ideas?

    • @Kami no i don't. why don't you go to Dr. Shoemakers site and ask him for a lead. I don't treat this stuff at all.

  28. Thanks, I did that and am hoping for a reply.

  29. This from a 2009 NIH study: (in case anyone thinks you are just making this stuff up )http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2667664/
    Leptin and the hypothalamic-pituitary-thyroid axis

    A significant role of leptin in the regulation of the hypothalamic-pituitary-thyroid axis has been well established in humans (6-8). Subjects with leptin receptor mutations present with hypothalamic hypothyroidism, low circulating thyroxine concentrations, normal circulating basal thyroid-stimulating hormone (TSH), and a sustained response of TSH to a thyroid-releasing hormone challenge (18). Healthy, normal-weight subjects exhibit a similar leptin and TSH 24-h secretion pattern that is impaired in subjects with congenital leptin deficiency (21). Leptin administration in replacement doses to healthy lean men during a 3-d starvation period significantly blunted the fasting-induced decrease in TSH pulsatility and increased free thyroxine to concentrations within the normal range (19). In contrast, in leptin-replete states, leptin seems to lack the ability to regulate the hypothalamic-pituitary-thyroid axis (7, 21). These data indicate that leptin may regulate TSH, influencing secondarily circulating thyroxine concentrations in leptin-deplete states. The exact mechanisms underlying these effects are still not completely understood and require further investigation.

    • @Akman……i had to laugh that you think I care if people think I am making this up! Our biology has a certain gravity to it. When your not getting the answers from your doc its time you look to evolutionary biology to get the answers. There are a lot more leptin surprises yet to be unleashed here.

  30. dear dr k

    6 months ago, i was told i have lyme via + igenex (bands 31,41) & very elevated rickettsia titers. low MSH, low VIP, but normal leptin. on top of all my other neurological woes, my spine is a disaster–arthritic and degenerated way beyond my years according to many docs. 5 herniations and bulges at nearly every other level. any connection in your experience as a neurosurgeon b/w these biotoxins and spinal/disc degeneration? just wondering.

  31. Doc, what is the downside of using abx's? I know it will kill good and bad flora, but is the rebuild difficult? We wonder if just taking acidolphulous caps are enough to restore balance.

    Can you give some insight into getting the all-important GUT back in good working order?

    Many folks I've read about did okay on abx at first, then other problems arose. There has to be a logical pathway back to balance, and since you're so dang good at the 30k view…

  32. @binky I doubt they are related in etiology. It sounds like your DDD preceded your Lyme. But your Lyme will make your pain from your back a lot worse. My advice is that you treat the lyme to completion and then you work on resolving your spine issues. You must control leptin to maximize your outcomes. This requires you eating a good paleo template always. With your spine you have no room for any trip ups. Make sure you follow your HS CRP and VIT D levels every 6 months……you must maximize them and this will give you feedback on how well youre doing on your paleo template

  33. @Martin For what? For Lyme they are critical. For elective surgery I think they are worthless and may actually hurt you. Martin my thoughts on most neolithic disease degeneration is that the gut is main portal of entry so I think you must protect your gut well. Im ok with probiotics but I really am a large fan of natural probiotic foods. for myself I have been a coconut oil bone broth drinking guy for the last 4 years. I use a lot of pickles, saurkraut , kimchee, kombucha. I recently began using Kevita coconut natural probiotic drinks routinely and I have to say I think they are pretty solid. The real Key Martin is to avoid things that open your gut to inflammation. For me I have to avoid Tannins and that is a killer because I enjoy wine with dinner. Very rarely will I do it because it destroys my sleep. So I know that wine is a no no for me because tannins kill my gut. I also stopped using dairy because I noticed some things on my labs and I cut them out and my labs dramatically improved. I believe Martin that to protect yoru house you must tinker with what works best for your gut. For me tannins and dairy are no no's. I also have limited all nightshades but I can tolerate eggplants but rarely eat them. I also can tolerate tomatoes and most chili's but I limit them. I do not eat any potatoes at all. You just must test yourself to find out what works.

  34. when one knows something is disturbing the gut?. Is bloating a good indicator?. For instance, cow milk and some nuts produce me bloating, does it mean they are no ok and it's prudent to remove them?.


  35. Hi Jack,

    I've noticed your move away from dairy over the past months. The last time I remember you mentioning it was in reference to only eating it in the form of aged cheese for your primary source of K2 and that it help soften your skin something that K2 supplementation didn't do so well. Two questions for you if you will.

    1) What is your current source of K2 if you are laying off aged hard cheeses? For me the K2 supps don't have the same effect as the aged cheese but I have a dairy problem too. Have you tried FCLO or the butter product from green pastures?. Richard Nikoley reports smooth teeth when only taking it and not the supps from Life Extensions or Thorne for instance.

    2)Maybe you could blog your test results in real time and show how you change your diet in accordance? Only the whole world would be interested in that 🙂 Take care.

    • @Perry I was never a big dairy guy ever. I only advocate high fat low protein dairy. Pastured butter raw cream, eggs, and raw milk cheese from France (beaufort Herve Mons) is all I do and its not a lot. If you go back and look at some of my earlier public Hacks on paleohacks of Mr. Kronk see what I told him. I was french fried for it…….but I know it was correct. The entire VAP blog post was written just for him and I should have kept that on back I think now.

      As for my labs I do not see the point. I hack myself like a mad man. When you see what I just did to myself for the sake of a hack and to prove a very controversial point you will understand why I will never post my labs. I want no one doing what I do without the knowledge of what they are doing good, bad or indifferent. I view all diseases now thru an evolutionary prism and this really separates me from the pack. Many do not know how to do it…….but if you look at my last two blog posts you are getting a birds eye seat as to why I get things and why conventional medicine struggles with some disease they have no answer for. Its all in how you look at a problem

  36. P.s. By test results I mean your labs. Thanks

  37. Doc,

    Specific question while on the subject of and labs, for kids (age 8 and up)You have mentioned you start your top-down assessment from hs-CRP and (0,25)OH D3 serum levels.

    I guess D3 is universally applicable, but is the hs-CRP test and ranges similarly applicable to kids too? What would be the basic tests to keep track of in (healthy) kids to ensure they grow optimally?

  38. Here is a link to the Visual test if anyone wants to take it online.

    It is about molds.

    Mold likes darkness and humidity.

    People feel bad when humidity is less than 30%, comfort zone (35-55)%

    Winter is time of very low humidity and nose bleeds in my house.

    I have forced hot air heating in my home.

    There is build in evaporative humidifier, the best they were able to come up with.

    I have got 2 other (noisy) humidifiers from Home Depot, installed them in my basement feed them with RO water.

    That gives me desired (35-40)% in the house.

    But that gives me 65% humidity in my basement.

    Am I asking for trouble.

    Any better idea?


  39. I have heard about certain things growing in regions where they can provide an antidote to other things also in the area – in regions with high humidity where mold could be a problem, coconuts also grow plentifully and perhaps taking them has a preventative or protective effect. With Lyme disease, in addition to the way that you have outlined, would it be possible to have another layer of affliction as the result of powerful antibiotics given to treat it, perhaps resulting in fungus if good bacteria is undermined – then when coconut oil is given, it clears out the bacteria – brain fog from Lyme disease in one case alleviated by taking coconut oil.

  40. Dr. Kruse, do you know what doses of CSM and Actos including frequency are effective to remove / reduce the Biotoxins. Thanks in Advance…

    • @Gary CSM is 4 g orally 3 times a day before meals. Actos is the same dose that an MD would use to treat a T2D. But here is the key Gary…….you must eat a ketogenic paleo diet when you use both to best clear the toxin. If you eat even one thing that deactives PPAR gamma you screw the pooch for neurotoxin clearance. You should do this with an ID doctor or a doctor who is familiar with the Shoemaker protocol.

  41. You say that 3 weeks of antibiotics is enough to kill the Lyme, but according to all I've read if you have had Lyme for more than a few months (and are considered 'Chronic Lyme'), then 3 weeks has been proven to not work at all. Actually, I read yesterday that no amount of antibiotics will kill it all after it has become chronic.

    Are you saying that 3 weeks of antibiotics plus getting rid of the biotoxins will actually get rid of all the Lyme?

    Thank you!

    • @Gina……I dont treat Lyme disease, ID people do. What I posted here was the standard new thinking boilerplate that most will recite back to you. If you have acute Lyme 3 weeks of treatment usually works but some need more…….some dont if they do not have the HLA DR issue…….most people do not get treated for acute Lyme…….they find it after it is chronic and the treatment changes…….but uses the same principle of toxin/bacteria killing and then clearance and then following labs to gauge results. Go see a doctor who knows this data inside and out. There are not that many in view sadly.

  42. @Jules The Lyme lab work up from this protocol is extensive.

    1. History and Physical

    2. VCS test to confirm positive result. Once postive then draw labs

    3.EKG, Pulmonary Function tests, Urine SG with a sediment analysis.

    4. HLA DR, leptin level, MSH level, ADH, ACTH, Serum and urine osmolarity, cortisol level, androstenedione, DHEA-s, total and free testosterone, PAI-1, GGTP, TNF, MMP9, Chem 20, HS CRP, and a CBC, save 2 SST tubes in 4 aliquots for cytokine studies because cytokine studies must be spun within 5 minutes of draw. MSH requires a cooled lavender tube with Tasylol in it. HLA is sent room temp all others must be frozen.

    5. Deep aerobic nasal swab done and sent to Esoterix for isolation of MRCoNS bacteria.

    That is all I know.

  43. Okay Lymie's, here's some fat to chew on if you haven't seen it yet.

    Just had my blood drawn for HLA DR.

    MSH, C4a, and others to follow before seeing doc to get this handled.

    From Dr. Shoemaker's site:

    Also copied this from: http://puttinglymebehindyou.wordpress.com/


    Dr. Shoemaker:

    92% of people with biotoxin illness have a positive VCS test. The test can be done online at SurvivingMold.com. A negative VCS test does not rule out biotoxin illness as there can be false-negative results.

    ADH (anti-diuretic hormone) deficiency is almost universal in biotoxin illness. When MSH is low, ADH is generally low. In fact, when MSH is low, many things go wrong in the Biotoxin Pathway.

    When ADH is an issue, you lose water. Salt then gets dumped onto the skin via the sweat glands. Dr. Shoemaker did sweat chloride tests and found that when people experienced static shocks, they had high chlorides.

    "Doing air sampling is the stupidest thing I have ever heard in my life," stated Dr. Shoemaker.

    MSH and VIP are regulatory peptides. VIP is now available as a nasal spray that can be used after you have followed all of the required steps in his treatment program. It will not work if done without having done the earlier steps. MSH is not available yet. ADH is another regulatory peptide.

    When you lose control of inflammation, inflammation goes wild. If you don't control inflammation, it will chew you up.

    Uncontrolled inflammation can be evaluated using C4a, MMP-9, and TGF-b1 testing.

    Reduced MSH is a co-factor which can lead to MARCoNS, a nasal staph infection. MARCoNS activates inflammation. MARCoNS can also produce biofilms and biotoxins.

    TGF-b1 can be an indicator of autoimmunity. It can lead to changes in lung tissue and symptoms that are asthma-like.

    The condition that Dr. Shoemaker speaks of is not a "mitochondrial disease" but an oxygen delivery deficiency."

    To read the complete blog, please visit BetterHealthGuy.com here:

  44. This statement jumped out at me: "The condition that Dr. Shoemaker speaks of is not a "mitochondrial disease", but an oxygen delivery deficiency."

    I must go back to the blogposts to get more understanding on this. How about a clue for me to get started, Dr. K?

  45. nuttmegs17 says:


    honored that i prompted you to write this blog – its got so much info its overwhelming. Got the CD-57 test: results below

    I also took the free biotoxin test you linked to and I'm happy to say i passed.

    what do you think of these results? I'm currently figuring out next steps. I guess an ID doc through Dr Shoemakers website?

    cd-57 panel

    Ranges in parenthesis

    CD8-/CD 57+ Lymphs 4.0 (2.0 -17.0)

    Abs CD8-CD57 120 (60-360)

    WBC 8.8 (4.0-10.5)

    RBC 4.59 (3.8 – 5.10)

    Hemoglobin 14.0 (11.5-15.5)

    Hematocrit 43.4 (34.0- 44.0)

    MCV 95 (80-98)

    MCH 30.5 (27 – 34)

    MCHC 32.3 (32 – 36)

    RDW 13.2 (11.7 – 15.0)

    Platelets 238 ( 140 – 415)

    Neutrophils 58 (40-74)

    Lymphs 34 (14-46)

    Monocytes 5 (4-13)

    Eos 2 (0-7)

    Nothing jumps out at me…so hoping I'm ok on the Lyme front?

    • @nuttmegs. It might indicate a biotoxin disease and not just lyme! I think contacting Shoemaker is a great idea because he is the expert in tis area. Im interested in these diseases because they link to leptin and clearly show how important it is from a 30k foot level to those who think leptin is a small factor.

  46. nuttmegs17 says:

    In one of your comments you said:

    In Fibromyalgia patients there is a serious leptin problem and it is the hardest biohack to perform on patients because it requires 18-36 months of optimal bio identical hormone treatment and regaining LS with the Leptin Rx is the first step.

    i do not have fibrom, but does that mean i might find help in pursuing bio-idential treatment for my low sex hormones, hashis and adrenal dysfunction?

  47. nuttmegs17 says:

    Thank you, Dr Kruse. I am working on it! shoemakers site requires signing up to get access to the doctor list…they haven't gotten back to me yet to approve my access. i'll keep you posted. this is all very interesting. next doc appt i have I will mention CSM- he's onboard with Dr Shoemaker so if i point your article out again and perhaps have Shoemaker sources with me, he may give it a try. i'll also continue to work on the bio-identical side….lots to consider.

  48. nuttmegs17 says:

    and i'm sorry "what implies this" i had a couple of posts so wasnt sure which one you were referring to. thank you again!

  49. nuttmegs17 says:

    Just reread your comment on MDA's monster leptin thread about hashi's and the role of glutathione…amazing how this all ties together….glutathione helps to detoxify as well… i finally got in the mail today the lab orders so I can get my levels tested…already on milk thistle and liver supporting extracts but now that the biotoxin is on my radar glutathione seems even more important than ever…ties the adrenals, hashis, potential biotoxin to leptin as well…crazy how this is all fitting together….plus CSM…thanks for the information!

  50. @nuttmegs. Let us know if you get thru to Dr. Shoemaker. I've done the Visual test (failed), bought the next package of tests/info, and read his simplified protocol. But it does NOT include info on abx's and how to take them if your a longtime sufferer. I emailed them twice with no response – once about the abx protocol, once for a doctor refferal. It's been over a week. I believe his work is spot on, and Dr Kruse's view just ties it together. I've started reading other forums where Shoemaker's proto is used and there is a lot of mixed reviews. All sorts of factors, to be sure. What I'm looking for are the connections that perhaps will explain why we get different results. I'm also looking for a doc close by that does this CSM/Actos proto and knows the correct test codes to avoid mistakes. I'm reading that this is a problem. Something about a "HLA DRB DQB" being the correct test to get. I just paid $240 for a HLA DR and am now wondering if I've wasted my money. There is a draw sheet that Dr S uses that apparently makes thus easier and less costly. I'm working on how to get access to correct info. It's a tough road sometimes.

  51. nuttmegs17 says:

    I will do that Martin – please do the same if you get through! I know there is at least one other person trying to get through as well…hopefully one of us will be successful!

  52. nuttmegs17 says:

    sorry – but what did you mean by "it implies this" wasnt sure which comment of mine you were referring to!

    the glutathione link is getting a closer look at MDA even as we speak. super interesting stuff!

  53. For those who wanted a larger diagram, here is the downloadable and printable PDF:


  54. Nuttmegs17 says:

    Just found out from someone else that the mold site did not give any referring docs 🙁 Might wand to check out ILADS and get referring docs from there…could always narrow it down and ask them if they are familiar with Dr. Shoemaker's protocols…thats what I'm doing at least

  55. Martin – this is the information on the labs:

  56. KathleenM says:

    Dr. Jack, I'm curious about what SueJeanne asked above in #57. My doc is very hesitant to do antibiotics since I'm so candida-ridden. He's wanting me to just stick with candida protocol and your Rx in hopes to take care of my lyme symptoms. I've been experimenting on how much coconut oil I can take w/o getting the runs, and I have to say I've yet to reach it! I'm now taking roughly 8 to 10 tblsp a day. I should buy stock in this! I've had a few herx reactions but they're not as strong as before I started the Rx. Going ketogenic paleo and following your Rx is helping tremendously. Still dealing with sugar hunger but not as bad as before Rx. The doc's theory is that maybe with the last 3 years of battling the candida with various antifungal supplements and taking in coconut oil has also been taking care of any lyme I may/may not have. The lupus and muscle pain has been gradually disappearing to where there are now days I realize I had very little pain. Yippee! Sorry, rambling here. So, what is your opinion?

    • @Kathleen M if you have Candida I think you need to eradicate it and follow the metametrix GI fx testing constantly sometimes for three yrs. Treating ti with just food will knock it down…….but wont get rid of it, and to get to optimal you must eradicate the fungus. Its a pain but it well worth the effort. If you talk to patients who have done it they will tell you its no fun but their life was gien back to them post treatment.

  57. I've come to find out found out the "HLA" test code Dr. Shoemaker uses for his patients is 012542.

    It's listed on his website's Physician Order Sheet as "HLA DR PCR", and that's the info that's in many places I've been studying, but seems there is a really specific HLA test called, "HLA DRB, DQB" that is the correct one when you pull that number from the order sheet mentioned above.


  58. Thanks, Dr. Jack. That's what I keep coming back to – eradicate the fungus first. Such an impatient person I am! I want to get well NOW!!! I'm following a pretty good candida elimination protocol that I found, ran it by the doc, and he said go for it. That's been going for about 2-3 years now. But this protocol allows small amounts of starch after a tough elimination round. Every time I'd finish it and move to the next phase, the sugar hunger was back big time. I thank God I found out about leptin and your blog! Oh and going paleo! That's been the missing puzzle piece. I've sorta been on the Leptin Rx and the gut fix for about 2 months now and I feel alot better. I need to hunker down and really stick with it 100% if I really want to feel better, which I really, really, really want to do! Reading your perspective blog has given me incentive. Thanks!

  59. In reading Dr. Shoemaker, VIP (Vasoactive Intestinal Peptide) comes up often. In your research, what have you learned?

    "VIP regulates the circadian rhythm. The pituitary-hypothalamic portal is involved in the production of MSH. When fixing MSH, you fix the androgen problems. When VIP is on board, androgens normalize. VIP fixes Vitamin D. VIP is a master controller of inflammation."

    "VIP downregulates cytokines and TGF-b1. It also raises TReg cells. It improves exercise tolerance.

    – ERMI must be less than 2 to use VIP. Nasal culture has to be negative. VCS needs to be normal. VIP is then available as a nasal spray.

    – People have tried to shortcut the process and skip steps and go straight to VIP, but this has proven not to work when doing things out of order.

    – VIP has been well-tolerated generally, but it should be monitored by the prescribing doctor as there can always be side effects.

    – All of the sickest patients have low VIP.

    – When underlying inflammation has not been addressed prior to VIP use, a lack of any benefit has been observed."


    • @Martin have faith in me……i have a monster post coming up about circadian biology and why most doctors do not get it……..the reason is simple. No studies are done taking these factors into consideration so the real affects remain un-noticed. When you select out these issues in the environment and plan for them with a protocol…….amazing things happen to humans. This can be seen with my reset and my post leptin Rx. Many other physicians have come up to me and have been floored at the how well patients do on it once they wrap their head around why I do what do. VIP does tie to the cycles and it is a vasoactive gut protein. It again points out the fact that having your gut in ideal condition is part of optimal health. This is a big focus of my upcoming book.

  60. As you have been saying all along, anything that works to restore balance in human health is rooted in our primal, evolutionary, biology. How much more basic can one get then Light?Dark?!!!

    I have always been working backwards to find those principles – Weston Price, et al, and now you sir, are putting it all together – The Quilt. I envision docs and practitioners training along these principles you've tied together and continuing to change the paradigm.

    Looking forward to the book.


    • @Martin i promise you I have a bigger surprise in store for you in 2012 when the book comes out…….I can't blog about it yet…….but the biologic and scientific power of what I think I have found will make you realize that the answers are have right under our noses for far too long. My goal is to change how medicine looks at illness and wellness. The thread over at MDA is going to be the first medical textbook for the Primal Nation when we are done. The shear volume of information in that thread is staggering.

  61. Are CRP or Homocysteine levels any indicator as to whether one has a biotoxin? Asked another way, can one have low levels of inflammation as measured on a CRP or Homocysteine and still have a biotoxin?

  62. Jackie, check out C4a and MSH on Dr Shoemaker's website. http://www.survivingmold.com/
    He has a list of symptoms that is helpful in doing a clinical analysis. Also, look at doing a Visual Contrast test as another piece of data. 92% of biotoxin infected people test positive.

  63. Thanks Martin, I'm going to try to connect with you on the MDA site.

    So far the lab has botched my C4a and MSH tests 2 times.

    Anyone who is getting these tests – make sure you read on the LabCorp site how the lab is supposed to handle these draws. My suggestion is to call ahead and make sure that the lab has the kits and that the vials have not expired. Take a copy of the instructions and be assertive in making sure they follow them.

  64. Dr Kruse, I have picked your brain at work (I'm a Summit RN), and I have just recently found your website. I am studying for my Masters in FNP/Holistic NP, both to assist my patients with a proactive approach to health and wellbeing, and to help myself personally. I am intrigued by the information found through your website and I am hungry (and desperate) for more information. I have tried to discuss an integrative approach to my own health issues with my PCP to no avail. He is stuck inside the traditional approach box. I have seen a handful of practitioners that practice in Bio-identical hormones, but I am still searching for a MD that will look at the total picture, the way I aspire to do with my patients. I have been diagnosed with FM (after living in a moldy house, also grew up in a tick infested area), have had a total hysterectomy/oophorectomy, and experienced an MI one year after TAH, therefore, I turned to alternative therapy in attempt to feel normal. I continue to struggle with FM, hormone imbalance, RLS, CFS, NO libido, and weight gain. Can you suggest MD's in the Nashville area that subscribe to your approach to assist me in reaching my normalcy? I am drinking in the knowledge of Leptin, and will soon try to begin my transformation.

    • @Lisa if you work at summit with me talk to me and let me know. I have someone in mind for you who is ideal to help you. My condolences about working at Summit too.

      • I found your article informative yet find your approach to treating Lyme disease and mold toxins a bit too toxic and brittle for my holistic taste and too simplistic. It is a complex disease and one treatment does not fit all Lyme patients just like one diet is not rght for everyone.

        Many Lyme doctors no longer put much weight in the CD57 being a good indicator of how the body is doing with Lyme disease so they do not use the test. Many variables like co infections can throw off the test and who does not have co infections if they have Lyme Disease?

        Dr. S. ordered three CD57 tests for me when I was first diagnosed in 2006. My score went down with treatment not up. I was told with my first high CD57 score I had a very high immunity to Lyme… Right.. Unless someone’s insurance covers the test why do in my personal opinion.

        Photon treatment in German and Stephen Buhners herbs have helped me the most not that I am well now due to a pesticide exposure. People are getting well in many ways, ozone therapy, bee venom therapy and with Chinese Medicine just to name a few.

        • Marjorie that article was written years ago. IF you have read my latest work on immune regulation you’d see biophysics is anything but simplistic. The light therapy youre using is one of the better ways to help these spectrum of diseases. Most people with them are losing massive amounts of ELF-UV light from cells. You’d be wise to read Roeland van Wijk’s recent book. Mold, fungi, and parasite diseases are usually tied to a severe lack of UV exposure or a severe inability to assimilate that particular frequency of light from full spectrum light. Focus on that and you’ll like see an huge improvement.

  65. Hi Doctor Kruse, thnx for your wonderful blog! My question is similar to LIsa's. I am 36yo and I live in Orange County, in Laguna Beach area, and have spent lots of time and money trying to deal with CFS, Secondary Amenorrhea (and osteoporosis) not elevated by the year's worth use of Bio-Identical Estrogen and Progesterone; Intermittent Hemolytic Anemia (bone marrow biopsy showed no concern); recently diagnosed hypothyroid; serious viral load and manifestation (treated with the Canadian drug Imunovir); now I realize that I had Leaky Gut and may be more all this time… insomniac all my life; seriously elevated cortisol levels non-stop (blood and 24 urinary tests confirmed many times). Very low BP and HR. Fatigue, brain fog. What affects me the most is the inability to breathe deeply and fully which in turn makes me light dizzy, foggy, weak, unbalanced…and suffocating most days of the week (nothing wrong with my lungs) – I think understand its the lack of oxygen supply to my brain. The only way to elevate this is to exercise, so I do make myself move, which at times is very hard to start due to low BP and HR, but then the positive effects don't last more then couple of hours. I think that the reason why it makes me feel better is that it temporarily restores the blood flow to the brain and I feel normal for a while.

    Also, I can't seem to gain a bit more weight (odd – with such an elevated cortisol!), which was never a problem when I was a teenager. The Docs that I visited can't deal with the scope of the health problems that I have, and I can't blame them…hard to understand what condition is the cause of this cascade and what is the consequence.

    So its been 18 years of this joy ride, and I have put my life on hold in so many ways… I know its a long shot, but I was wondering if there is someone you actually know in my area who you think may be able to help me and make a difference…I would trust your judgement.

    • @Irina I am sorry to say I do not know anyone in your area that can help the CFS but I would suggest you contact Dr. Shoemaker and enlist his help. As for the help for this condition. My blog series on factor X, cold thermogenesis is something you must begin to think about and one I think you need to consider in helping yourself. The beauty of it is it will help improve many of the things in the bio toxin pathways that afflict you now and you can do it from the confines of your own home without a doctor. I recently laid my own protocol out on 2/11/12 in blog forum and I would strongly suggest you read it.

  66. HI Irina, I am going to visit a clinic in CA for this reason.–PM me on the mda forum. http://www.marksdailyapple.com/forum/thread32345-…. My Name there is freshveggies.

  67. @Kami Thnx for answering:-) Kami, I am not registered on MDA even though I do read it…any other way I can contact you? Would love to share…

  68. Dr. Kruse, can't wait to read it – where can I find your forum?

    • @Irina right now I am an internet nomad……..the road becomes my bride……..I go where I must but soon I will have a permanent home right here on my new website and forum to lay it all down right here.

      You can find the Monster thread over at MDA under the nutrition forum tab. Look for my name and the thread that is over 1700 pages. You cant miss it.

  69. Dr Kruse… Sorry to bug you with this, but when you suggested to read "protocol …on 2/11/12 in blog forum" – did you mean MDA? If yes, this is the link to page with this date and its not there.. http://www.marksdailyapple.com/forum/thread32345-
    Can you pls direct me?

  70. Hi Dr. K – I am waiting to see my new Dr who will treat biotoxins, but can't get in until 3/13. My sleep stinks. Non existant. Any thoughts while I wait—what could help a biotoxic brain to sleep?

  71. Thank you. I am going to jump in. I am using CSM so I should be able to clear the biotoxins if they move more from the cold.

  72. Okay, before you Dr. Kruse I had never even heard of MSH. Would have never considered a biotoxin. Today (my birthday) I got my MSH results – LOW. Rather than it get me down I feel like I have been given a key to door that leads to my optimal future. Thank you for that key, and your patience with folks like me who have a brain fog and poor comprehension and assimilation of new info. I cried today, but it was a happy cry. I'M NOT A CRAZY LADY! When I get this cleared I have an action plan to change a corner of the world with this info.

  73. I'm with you, Jackie.

    I shed a tear today after reading Doc's latest post. For the first time in decades, I can envision a way forward, maybe backward is the right word, to a body that is tuned to this World we live on. Light, Cold, primal nourishment, and creating my reality thru my expanding perspective. Doc is showing us the way through his vision and work.

    I just knew there were answers on how to get Optimal out there somewhere!

    I am happy now.


  74. I just got my results back today and my MSH was <8. That explains the sleep issue. Can't wait to see my doctor on March 13.

    • @Kami It explains a lot more. That is the source of your fatigue too. It means you adrenal gland is shut off at the brain level and so is your endocabinoid system. It also means you are supersentive to pain and all cytokines.

  75. Hi Dr. Kruse, you posted this: "Leptin controls the controlling action of prolactin on the HPA axis release because it controls the cleavage products of POMC, namely alpha MSH and b-endorphin which both are excititory to PRL release. Leptin sensitivity directly controls the activity of these two peptides….What if LR came first then because of that breakdown I got biotoxins. Could that be the path?

    Dr. Shoemaker says it is 25% of the population that are susceptible for it because of the HLA genes they have. I was such a strong and healthy child, then it fell apart at 15. I think that is when LR showed its ugly side. LR= low MSH and that is what shows up in biotoxic people.

    • @Kami……correct guess what controls the ancient biochemical pathway Im working out now in the bolo series on cold thermogenesis? Leptin controls alpha MSH release………cold increases it better than any substance on the planet. You better pay attention to this. It could change your life.

  76. I am seeing a doctor about my biotoxins March 13. If he is going to help correct these pathways possibly using drugs and supplements? Will this be ok? I don't want to take any detours by what a doctor might give me to stop the biotoxin storms. I am at the point of being so tired of the way CW has made my body worse. I know I am in charge, but there has to be a level of trust I put in the doctor too. This doctor does conferences with Shoemaker.

  77. Sourpusscandy says:

    I just found a documentary about Lyme, symptoms, diagnosis, and the medical establishment conspiracy to deny it. More excerpts on the youtube channel.


  78. I’m coming late to the party by the looks of it, just found this blog once I realized the mold exposure might be a problem with why I’m stalling. I’ve ordered an ERMI test to see how bad the mold is in our place, am also looking to move in the near future, sooner if we can get out of our lease due to mold in the apt. I’m having problems finding a doctor to do the testing Dr. Shoemaker talks about on his website, when I talked to someone at Mycometric she told me to look for a “Neurotoxin” specialist, my insurance hasn’t heard of this type of doctor? I called the local Immunologist office, talked to 3 different offices and they hadn’t heard of it either? Am I looking for the wrong thing or what? My family doctor won’t order them because she says they are very expensive, hmm well what’s more expensive getting sicker or getting tests done? If someone could steer me towards the type of doctor I should be looking for I’d really appreciate it. Also Nuttmegs17 and Martin, how are your problems coming along, have you had any luck with Dr shoemakers office? Kami, where are you located, would be fantastic if I could go to the same doctor who is treating you for biotoxins? I seem to have so many problems trying to find out medical information because things are done so differently down here, I’m from Canada, when I lived there I just went to the doc and they sent me where I needed to go, no questions about cost or whatever, sigh* I find that I have to do all the leg work when it comes to finding the medical information I need and even then I can’t seem to get it done. I don’t think I’m asking the right questions.

  79. yeah I’ve done that, she didn’t have a doctor in kentucky, I’m waiting now to hear from the people that do the ERMI testing, she said they would have doctor referrals, but have to get the test done first, thanks for your help Dr K, it’s much appreciated, by the way, my sister noticed a huge difference in my appearance even tho I’ve only lost about 17lbs since she last saw me. She thought it was alot more, so things are moving, I just need to learn patience, after all as you say, it took me 54 years to get in this shape, so I can’t expect it to disappear overnight.

    • @Elaeanor that is so true…….but your attitude is rockstarish and that tells me you wont give up until optimal is yours.

  80. Eleanor, welcome to where I believe you will find a way out of biotoxin illness. PM me any time. I have much to share.

    I had no luck getting referrals from Shoemaker. Not sure why.

    I searched for docs by goggling and finally found one in Atlanta that I think is good. He has a doctor’s biotoxin study group with docs all over the country. I will post something on there to try and get you someone close.

    I’m waiting to start Cold Thermogenesis until after I take cholestyramine (CSM) and clear some biotoxins. But after all these years, I’m tempted to start CT now and ride it out. If CT raises aMSH, ACTH, and others, what would happen? Would one offset the other? I’m already sick as hell, so if there’s a chance…

    Dr. Kruse, at the tail end of Sean’s podcast a few weeks ago, a caller asked abut Lyme and you stated that Shoemaker was missing something. What is he not seeing? Shoemaker even wrote a book on weight loss and he’s fat as can be!!!!!!

    I posted some CT quotes about raising aMSH from Dr. Kruse on the doc/biotoxn blog to start them thinking, but not much response. I would have thought this would have lit them on fire! Leptin! aMSH raising! What’s not to love?!

    I have spent the last four weeks remediating my home and dont have the second ERMI test done. FIrst was 24!!! But no water damage or intrusion. Odd, but my collection method my have skewed things high. Doc visit in 3.5 weeks, can hardly wait.

    But I keep eyeing that deep, beautiful porcelain tub in the master bath…..


  81. Eleanor, here is a lead for a doc:

    “They can contact me through my website at http://www.the-healthy-path.org if they are interested.”


  82. wow fantastic Martin, I will give her office a call in the morning. Oh I’m so excited,it will be great to be taken seriously, I’ve spent hours on the phone trying to find a doc, had one call me back and told me everything I’m doing is wrong.She went through Dr Shoemakers website and called him a quack. Warned me not to get involved with a doc on the internet, I made the mistake of mentioning Paleo and she was off on another tangent, didn’t even get to CT, can imagine what that would’ve done to her. I think we just see the tip of the iceberg compared to what Dr K has to fight against every day amongst his peers.

    CT has really brought my blood sugar down and I know it’s helping re-organize my fat, lol that sounds weird but don’t know how else to describe it. Once I can get this biotoxin illness fixed I know I’ll be on the road to wellness. Frustrating how hard it is to find doctor’s to help, I’m going to change my primary care doc because she just refuses to order tests since I’m getting the information from this website, I talked to Labcorp about the test Dr. K mentions, the alpha msh, vit d and hs crp and they will do them but only with a doc’s order. Might have more luck with the doc you found for me, will keep yu postd. Hmm how do we pm on here, in the forum? I’m snowyky in there if you’d like to talk there, thanks again

  83. Quack, indeed. Conventional Wisdom at it’s worst.

    We have a lab in our small town that services the local medical center (lots of retirees up here) and I am able to order any test without a doctor. I self-pay with credit card. Cheaper rate than insurance, too. My HLA DRB DRBQ was $250, aMSH $200, vit D $40, and HS CRP $40.

    It is worth a try to find a lab locally.

    So you’re doing CT with a biotoxin illness? I am under the impression that liberating the toxins from fat will make one very sick if you have one of the susceptible haplotypes. You have not done the HLA test? I’d like to know more about how you are doing with CT.

    I am not coming at CT from an overweight condition. I am 5’11” 138 lbs. but I still wonder how I will do with CT. I read the success stories and get so excited! I did leptin reset protocol for two months and my belly fat went away. Lost about 12 pounds. Nausea went away, appetite way up, strength up a little, cravings down. But pain is still here, fatigue is bad, cognitive awful.


  84. I haven’t done any tests other then the basic ones my doctor ordered, interesting that you have a lab that will do the tests without a doctor, apparently I’m going about it the wrong way. I contacted Labcorp and they need a doctor to order the tests, and apparently Labcorp is the only one that does the Alpha msh one right, I get so tired of all this insurance crap, the doctor in ohio isn’t covered by our insurance of course, no surprise, but both my husband and I are going to see her.

    The thing is I don’t know if I have biotoxin illness, I think I do because of what happened after we moved to this apartment, and now my husband is also getting the same symptoms. I was in such bad shape within 3 months after we moved in here, that my family flew us back up to Canada to go the a medicine man, we went through the sweatlodge which got rid of most of our breathing problems, he also performed a healing ceremony for me, all I know is, I went up there in a wheelchair and left the medicine man’s house 3 days later able to walk on my own, go up steps with no help. When we flew back down to Kentucky, I had no problems crusing around the Chicago airport, didn’t need a wheelchair on the trip home. This was 3 years ago, I’ve since been using the cpap machine at night, which I think is what has saved me because I’m not breathing in the foul air, I also use a steroid inhaler twice a day for asthma. I work at home so I’m constantly around the mold, although my office is in the front of the house and the water damage was in the master bedroom.

    The reason I started looking into the biotoxin illness was because I’ve stalled on the leptin reset, even after I’ve added the CT protocol. Dr K says there is something else wrong but without being able to get the testing done I’m at a loss. I’m calling around to see if I can find another doctor in the area who will order the tests at Labcorp for me, but they don’t make it easy.

    I do have an appt with my family doctor tomorrow to see if she will run these 3 test Dr K mentioned if I can’t get the full testing done, they are the Alpha MSH, Vit D and HS CRP

    I did have problems when I first did the CT and Dr K said it was the toxins being dumped into the stomach from the liver, which were released from the fat, it lasted 5 days and only occasionally happens now. I’m on day 18 of CT, I start out with warm water in the tub and gradually add the cold once the water is about 2 or 3 inches deep, I put the tap on the coldest setting which is about 59* and getting warmer with the warm weather 😐 Once the water is high enough I add the ice, which is 25 lbs, which brings the water down to between 50* and 55*. The ice helps to numb the body so it’s not as bad as having cold showers, I still can’t have a solid cold shower without discomfort. I also started wearing socks and small gloves as those are the parts of my body that get real cold. I also wear a compression shirt and put 10lbs of ice on my stomach area held there with this ice garment I made, also put smaller ice garments on my upper arms. I can stay in the tub over an hour but my back and neck start to hurt from laying in the same position. One thing that has probably helped me with this is I’m from Canada, I grew up in the Arctic near Great Slave Lake, we had -60* weather there during the winter and I would run around with a typical young person garb, froze my ears once because I walked a couple of miles with pieced earrings in and they froze my lobs. Could wear any type of earring after that lol, was no longer allergic to cheap jewelry, up til then I could only wear real gold.

    The Labcorp cost for the 3 tests is $318 btw. Oh yes and I did the VCS test on Dr Shoemakers site and failed both eyes, got a positive for biotoxins. I don’t have the pain you talk about, just the lack of energy, shortness of breath and am stalled with the weightloss, I’m a large woman, and any change in diet should start the weight to move but it’s not. Let’s hope this is what is causing it and once it’s dealt with, I will start to lose weight and get healthier.

  85. Great info. I’m impressed that you did CT. I am thinking of starting after experiencing a slight shift in my chronic, unrelenting ache late yesterday. A change? Dare I hope?

    I have been in and around old houses most of my life and restored old homes at the end of my working so I’ve been around lots of moldy old structures. The fact that I have the 13-6-52A haplotype – one of the mold susceptible ones – makes me think about the struggle to thrive but also why I was not worse.

    So perhaps CT with it’s actions on hormones and pathways would really get me balanced and the releasing toxins may get eliminated somehow, like I was perhaps able to do all along. I haven’t felt bad ALL of my life!

    A HLA DRB DRBQ test would go along way in showing you what you face. When I found out, it had a calming effect. I know now. Before I blamed myself for being a loser.

    Thanks for sharing your info.


  86. Dr. K –

    I see in the above comment you suggested to Martin that he take CSM to clear toxins. I haven’t been officially diagnosed with Lyme as of yet (Western Blot was negative, but I’ve read it’s very inaccurate for chronic cases). I’m sure I have some sort of biotoxin illness going on as my current state of declining health began when I was exposed to mold in my basement. As soon as it was remediated I had an immediate improvement (though not recovery).

    I seem to be doing well with CT aside from the general detox effects. I guess my question is whether or not you’re aware of any side effects or negatives from taking the CSM if I’m not sure I need it?

    • @BJK if you read the article it depends if you can clear the toxins with your own immune system. This is tied to your HLA DR testing……or your alpha MSH level. Testing is always helpful.

  87. Thanks Dr. K. I am going to have the HLA DR test done. Will CT interfere with those results? I know I am currently detoxing from CT and believe my alpha MSH levels were very low, but I assume they are increasing as I am finally getting some color back in my skin and no longer look like death 😉

  88. Herbert Toll says:

    Doc, I’m a little concerned. I have read Shoemaker’s comments on not taking steroids while someone has a fungal infection and has low MSH and VIP, because it will impair the ACTH secretion and that will severely compromise one’s immune system.

    When I got very ill three years ago, I felt like it changed me in ways that have not resolved. While I was at my sickest (slight fever, no respiratory probs, severe headache, severe muscle pains, and extreme fatigue) I remembered I had some HC left over from a course I did two years previously and took about 5- 10 mg tabs aver the course of one day, all that I had left. It didn’t help much, as I was very sick.

    I had taken two years before for about 3 months and would average 50 mgs a day spread out in order to replicate rhythm. I did well, but started bruising and don’t like trying to guess what my body needs and weaned myself off successfully. I did better as the months went on and as I continued to eat traditional foods and other mineral balancing strategies.

    For two years, my health and well-being continued to improve. Then I went into the the extreme illness episode I mentioned. I continued my restorative living strategies, but something had changed. about two years into feeling lousy, I got desperate and ordered more HC, took about 40 mgs a day for a week and quit because it was doing very little to improve me and, quite frankly, I would forget to take it. Stopped quickly with no problems.

    Symptoms did not suddenly worsen, but instead have continued a slow decent into chronic fatigue, depression, flu-like symptoms, muscle aches, and a profound apathy that is hard to shake.

    Knowing the pathway like you do, what do you see and are there other tests I can get to find out if I’ve done damage, and, can it be repaired or overcome?

    I am seeing a mold doc who follows Shoemaker’s protocols and here are some labs:

    MSH <8 35 – 81
    VIP 42 0 – 58 (doc says it's questionable due to lab errors)
    ACTH 14 7.2 – 63.3
    TGF-b 10,820 344 – 2382
    TNFa 1.4 0 – 8.1
    HSCRP 3.57


  89. Herbert Toll says:

    Two more test results:

    MMP-9 263 ng/mL <984
    OSMOLALITY 289 278 – 305


  90. Herbert Toll says:

    Yet more…

    C4a 7691 0 – 2830 ng/mL
    VEGF 37 31 – 86 pg/mL
    ADH 2 1 – 13 pgmL

  91. Theresa Karnecki says:

    Where went the biotoxin chart mentioned by Resurgent in Comment #1???

  92. Dennis Walla says:

    Hey Doc…

    Great webinar on Tuesday night. Lots of great insights not posted on the current BG series. Thanks for the two hours and hope you enjoyed the “tannins” 🙂

    Relative to a-MSH and the production of endorphins or the lack thereof due to biotoxins and increased pain perception, what are your thoughts on Low Dose Naltrexone, LDN?

    From http://www.ldninfo.org

    “In general, people with diseases that are partially or largely triggered by a deficiency of endorphins (including cancer and autoimmune diseases), or are accelerated by a deficiency of endorphins (such as HIV/AIDS)restoration of the body’s normal production of endorphins is the major theraputic action of LDN.”

    I saw my doc yesterday and he brought it up relative to Hashimoto’s and/or a wrecked hypothalamus from AI. Thought this might improve sleep also.

    Re-reading CT-6 and 7 regarding increasing MSH.

    • @dennis….if you have hashi induce HPA damage LDN is pissing in the wind. You need a full bore approach and a gun ho endo……lots of luck with that. They are as aggressive as Switzerland has been in war.

  93. Erica Libby says:

    I came across your site while trying to find out what type of Dr. I should see to get tested for mold exposure. My Doctor said she didn’t know how to test me for that. I figure I have two options, find a Dr. she can refer me to or find out what lab test she should run. I was wondering if you could help me with that?

  94. Not sure if this will be seen but i’ll give it a go.

    I have an interesting situation in regards that i have all the symptoms of severe biotoxin illness and had long running adrenal fatigue before it, but i pass all of the “tests”. Passed the eye test twice, MMP-9 is normal, aMSH is normal, c4a is normal but low c3a and normal levels of cytokines. Other tests are off but none mentioned here. Lyme has come back negative but posotive for bartonella. Is there something missing here?

    • Yes……You are missing redox potential because you are lacking UV/IR light via your surfaces. You need to read Ubiquitination 22-25 , the redox Rx. Lyme is a disease of altered redox. Tissues with high energy demands, that are chronically light stressed suffer from a lower quantum yield. This is akin to placing a tarp over a tree to lower photosynthetic yields. This occurs in tissues such as the brain and the heart, contain a large number of mitochondria. They all rely on UV light exposure to drive RPE function of the eye clock and central retinal pathways that control all circadian regulators. Lyme affects these very active mitochondria-dense organs are more susceptible to reduction of the aerobic metabolism. Internal and external stressors, including cytokine up-regulation, pose a higher metabolic demand on the mitochondria to produce the necessary energy to maintain homeostasis. When the allostatic load becomes extreme due to extreme due to a blue light stress (the real cause of lyme persistence), the energy demands increase exponentially, taxing the mitochondria and resulting in mitochondrial dysfunction, which creates inefficient energy production and leads to energy deficit. This in turn creates a disparity between very high metabolic energy demands in inflammatory states and the actual energy deficit resulting from mitochondrial dysfunction. Lyme is always associated with bad sleep.This sleep is a sign of how bad your daily environment really is. UV and IR AM light normally lowers aberrant steroids (CT 7 blog) and nucleic acids in keratinocytes without any liberation of heat on the skin’s surface. This helps preventing aberrant optical scattering of cell signaling below (non linear optics). The epidermis has no nuclear DNA because as we rise to the surface DNA is exposed to a cells interior as the cell dies and DNA absorbs all UV light frequencies as a free chemical within the epidermis. It acts as a natural sun protectant or sun blocker. The more photodegredation we sense the more skin cells show up in the epidermis and the skin thickens in summer months. Melanin also absorbs all UV frequencies to serve as a storage protein for the power of UV light to give to other atoms and molecules in the skin. In this way your skin acts like a crystal. The skin’s layers serves as a supreme example of how the surface photochemistry controls the biochemistry of deeper layers in your skin and within the adipocytes below your basal layer of skin. The blood in these deeper layers acts as a conveyer belt carrying UV light along with flavinols, Vitamin K2, and phenols, quinones, and carotenoids. The blood embedded in fat cells can deliver their payload to mitochondria in your organs at cytochrome 1 that absorbs these frequencies. In Lyme, this is not the case. Nature uses surfaces, not as a dichotomy of the whole, instead, it is the connected parts contained within the surface working in unison because of the organization of atoms within that current environment within the surface and how that surface is organized which varies seasonally. Biochemistry is not deterministic as most believe. Paradox, enigma, and mystery in biology are just facades for how the indeterminism of how light interacts with the skin. From that interaction emerges that fundamental order of how the organ functions. It is our job to understand that natural order as things change based upon our environment. For example, think about the weather today while you lived, does it affect you? It too, is a surface effect on the Earth, that directly has a huge affect on your brain’s biology! That atoms in our brain can be determined while giving us the freedom of thought because both atoms and agency work at different scales of organization. Memory is nothing without the organization of thought. This is what is missing in Alzheimer’s disease. Remembering is worthless to a mind incapable of grasping ideas. In this way it should be easy to understand that biochemistry is determined by what happens to the surfaces in our eye, skin, lung, and gut. This is why circadian biology are incredibly important to how biochemistry unfolds in tissues below these surfaces . Biochemistry is thermoplastic and photo-plastic to light frequencies seasonal. This is true in plant photosynthesis and in our biology too. Natural harmony requires diurnal and seasonal destruction and renewal. Without renewal we cannot sustain life. We have to come apart, so we don’t fall apart.

      • Wow, that’s great. I am actually in the process of reading ubiquination 22-25 because you told a lady thats where i can find out how to raise progesterone in the brain (AF).

        Many of the redox signs i am good on but a few are glaringly bad. Ex; when the bartonella and M.E. hit my vascularity went down instantly. Literally in seconds. Also, ive never been above 7% body fat my whole life and within a couple months of M.E. my bf QUADRUPLED. That’s ascinine for me. IGF is another and that was bad with the adrenal fatigue.

        I look forward to getting more in depth. Do you have anything in your mitochondrial section (or anywhere else) about exercise intolerance specific to ME/CFS? It, also, came on instantly and has been a major roadblock.

        Thanks a lot.

  95. Hi Jack,

    You said something that really piqued my interest in this article. Ive had adrenal fatigue for a while but cant seem to get over it and my doctor is thinking lyme disease. Like you mention, despite a perfect diet i havent been able to get over my leaky gut. If i do in fact have lyme does that need to be treated first before the leaky gut and then adrenal fatigue can begin to heal? It seems like a catch 22, all the light and good food in the world isnt helping

  96. Dr, do you think lyme is a time sensitive disease? As in, you have to take the abx by a certain time otherwise your chances of killing it start to decline. Im working hard on redox’ing and detox’ing (in that order as you said) but i worry i may be putting the cart before the horse. My doc wants me to take the abx right away but i feel my body isn’t ready and wouldn’t be able to take over and clear everything in the state it’s in. This is something debated a lot within lyme circles, I’m wondering what your thoughts are.

    • very much so……….I believe Lyme changes how we handle light optically and it reduces energy transfers to lower regeneration programs.

      • Thanks for the quick response. So it may be best to get on the abx right away and just keep working on redox as i do? It seems so many fail to recover, i want to do it right

  97. This article is amazing, an so well-written! I’m 3 years into Lyme treatment and just now seeing a Shoemaker Doctor, as I’ve had some mold exposures in my home and see well the correlation it has on my symptoms. My main issue now is severe adrenal insufficiency. All my labs line up with what you mention, except for a glaring inconsistency – my leptin level is actually very LOW. (And I am very underweight.) I’m having a hard time finding an explanation for this and how it might affect my treatment. Any ideas?

  98. Do you know why Dr Shoemaker’s ref range (35-81) for MSH is different from LabCorp (0-40)? Mine is 33.

  99. Hi Dr. Kruse,

    Is there a way to increase alpha MSH directly or indirectly? I’ve already gone through various lyme treatments myself and yet still have downstream issues: weight gain and lots of hair loss being the two biggest physical effects. Been going to several prominent doctors and no one has been able to solve the issue.

    Thank you for your time!

  100. I am new to this recently diagnosed with mold. Low level Lyme load on the I spot test…i tried soon many Lyme protocols…nothing helped. I have heavy metals too. Which tests do I get? I live in Milwaukee, Wisconsin. Is there anyone around there that could possibly help me? Is the answer to all of this just sunlight and cold. I feel instantly better when I get into sunlight….on bright sunny days. Finally, what will help love rhetoric weight…that leptin rx supplement or what? Thank you for any answers!

    • Tests? none. You need to improve your cellular redox by understanding how sun light and the Earth’s magnetic flux rebuild this in cells naturally. Problem one: you live in a very low quantum yield place in Wisconsin. Do you think this is helping or hurting? not sure read on? Read my Redox blogs. There is two of them. The problem with these “discoveries” on mold and lyme is that they become systematized and programmed by paradigms.
      The public needs to realize that “systems and programs” are for computers…. ……and they are not designed for living things like us. We are designed to be wirelessly connected to the sun and fully connected to Earth to work properly in nature to remain well.
      We simply need to connect with nature and feel the zeitgebers……….and Mother Nature will take care of us. The Rx is simple but our brain’s wants desires and nedds of society and culture obscure that perspective.

  101. I’m two years into treating CIRS but I recaught marcons from my dog. I feel well most of the time and life is back to normal besides weight gain I can’t shed for the life of me. My MSH is still low because I still have marcons but hopefully will be starting VIP next month.

    What can I do in the meantime for the weight and will VIP fix this?

  102. Thanks Dr. Kruse! Great article and plan on starting to get AM sunlight tomorrow. Luckily I work from home so this is definitely possible for me.

    I live near the beach and it’s cloudy in the AM does it necessarily have to be sunny in order to get the UVA light? Also – for about how long will I need to be in the sunlight to benefit from it?


    • That depends on your mitochondrial haplotype, SNP’s and skin type before you can make an educated guess. When you put that stuff down in a journal on my forum then we can hash it all out.

  103. Hi Dr Kruse

    After 3 years of severe illness i finally just got diagnosed with lyme. One thing my doc tested was ADH and it came back low, she told me this as well as elevated hematocrit meant i am dehydrated.
    I’ve always drank a lot of spring water but reading through your blogs i see that isn’t enough. My question is, now that I’m adding seaweed to my broths as well as eating a bunch of seaweed, oysters and various seafood, grounding etc.. how long should it take someone to rehydrate with low ADH?

    • The sea made inside a cell is a function of the water a mitochondria makes under the power of sunlight. You need to read my Ubiquitination 5 blog .

      • OK i read it. It’s very complex, but what i take away is that DHA (and iodine from what i read in other blogs) tied to proper circadian rythems and cold water will reduce the swelling in your mitochondria. Add in i live in a low EMF environemnt and drink all my water while grounding, how ling does this take? Is it a weeks thing or a months-years thing?

        • Aerose you’ve been on this site a long time and you keep asking the same questions over and over again. The reason is simple: Your dopamine levels are low. Here is the answer. Read it 1000 times. HOW MUCH SUN TO GET SPHINXing? https://forum.jackkruse.com/index.php?threads/how-do-mthfr-snps-effect-redox-potential.17411/page-3#post-213969 If you don’t get it soon it means your dopamine level is demolished. ……it is time for you join and become a member because you are floundering here for three years now on your own left to your own devices. It might be wise for you to consider that. https://www.jackkruse.com/register/ You cannot get well in the same environment you got ill within. It’s a stark and unpleasant message that most people don’t want to ponder. All your question are about practical solutions and short cuts to help yourself. You cannot short a light problem. It is a quantized process with extreme specificity. You keep MISSING that. PRACTICAL SOLUTIONS DON”T WORK FOR LOW DOPAMINE PEOPLE: If you provide people with with simple practical solutions to their problems will they ever invest the time to solve them fundamentally? Can a picture of food, a sound bite or a tweet have enough data to really heal you? Or do you need skin in the game? It is time for you to get it.

          • Where did i say im not doing all of those things? I left the environment i got sick in 4 years ago, then left the next place because of what i learned here. I have literally been living in my car or outdoors camping for over 2 years now. I haven’t missed a single sunrise or sunset in that time apart from rainy days. I certainly have made some strides in some places but others not so much, or in this case have moved backwards and was trying to hash out why. I’ve moved 11 times in the past 2 years chasing the right environment as seasons change. I won’t let someone question my dedication. Sometimes things slip and i don’t know why, or they change and therefore i ask to try and adjust accordingly. It would make no sense to have a new or persistent problem and do nothing to change it.

  104. if I’m low MSH should i supplement MSH or is it not this easy?
    I’ve just gone through stem cells, three months ago and and dealign and doing the best I’ve done in forever, I’m not interest in testing cd57 or c4a right now army dr agrees since him doing well, why go down that rabbit hole?
    I’ve also had way lessening of shocks since stem cells. the might even be non existent. My MSH was previously low should i run lab again, or is taking MSH not harmful. I don’t want to interrupt other pathways etc.

  105. This is a fantastic article and more digestible than Shoemakers work.

    So I have chronic Lyme, the dreaded HLA genes (mold and chemical sensitivity). I’ve bern on the journey a long time. I’ve done 10 years of gut healing work. I folllow a Weston price diet but have done every elimination diet known to man. I’m holding on to 40lbs that won’t budge. I’ve done paleo and keto avd experimented with intermittent fasting but no loss.

    I have an elivated MMP9 but a normal (high end of range) Leptin. I’m wondering if you have further suggestions for weight loss.

    Also I did several of the suggested shoemaker labs but don’t know how to interpret them. I’m in S Cal and need a good Doc. I’m tired of wasting money of Dr that know less about all this than I do.


    • A new doc showed up today on the forum this weekend and he lives in a city I have tested which is horrible and already polluted with 5G as an earlier adopter and the said this, “I was already thinking about moving. I hate big cities.
      The EMF issues here explain why, in a state that has practically no ticks, there is an enormous amount of chronic Lyme disease.” So when all those “expert Lyme docs” tell ya you need a tick to get that disease……….run the other way. What causes this disease is the power denisty in the environment you’re in. Huge teaching point here folks made by a newbie. I’d suggest you realize Lyme is an electromagnetic pollution problem and not a strict bacterial issue.


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