Author: Michaela Falkner, NMD

Spring Allergies – tools for symptoms and prevention

By Michaela Falkner, NMD - Sinus and Allergies

With the blooming of another spring (even though it’s late this year), many of us can expect itchy eyes, postnasal drip, sneezing, and itchy noses. Allergies affect up to 26% of adults, according to the Allergy and Asthma Foundation of America. The symptoms don’t just cause discomfort, but can also come with fatigue, brain fog, headaches, and even tooth pain which can make day to day life uncomfortable.

Let’s look at options to blunt the effects of allergies on our lives:

Lifestyle

Use HEPA filters in your appliances like your vacuum, air conditioning, and air purifier.
Wear a mask when outside. Masks can help decrease the ability of pollen to contact your nose and lungs which can decrease allergy symptoms. Bonus points for washing your face, hair, or body after being outside as well.
Use natural cleaners to avoid irritating your sinuses, lungs, and eyes further.
Reduce eating your foods sensitivities and pro-inflammatory foods.

Over the Counter Options

Natural Options
- Look for ingredients like stinging nettle, NAC, vitamin C, quercitin to help with allergies.
- You can shop in Fullscript for natural options such as:
  - AllQlear – this egg-based supplement (not ok for egg allergies and vegans) is a delicious chewable that can help decrease inflammation in the respiratory tract.
  - D-Hist – we call this one “natural Benadryl.”
  - Aller-C – A blend of vitamin C, quercetin, and bromelain all help to stabilize mast cells (allergy cells) and decrease histamine.
  - Xlear nasal spray – this has xylitol and grapefruit seed extract to prohibit adherence of pollen and allergens to the nasal mucosa.
- Nasal Rinses – rinsing sinuses with saline solution will help to decrease symptoms of allergies. Look for NeilMed Sinus Rinse Kit available at most drug stores.
Over The Counter Medications
- Certain anti histamines are safer in the long term than others. Some medications, like Benadryl, have been found to have a high anticholinergic burden score, which can contribute to risk of dementia later in life (https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2736353). See how your OTC antihistamine stacks up here: https://www.acbcalc.com/

Desensitization Prescription Options:

Sublingual Immunotherapy (SLIT)
- For severe allergies, BNHC can prescribe a medication called sublingual immunotherapy (SLIT). This therapy is similar to allergy shots in that we help your immune system to become tolerant to ever increasing amounts of the allergen. We can tailor this prescription to your individual allergens, which we test through a blood test (no itchy skin scratch test here!). For more information look at https://www.allergychoices.com/ and you can schedule with Dr. Michaela Falkner if you’re interested!

Babesia – Another Common Tick Born Illness

By Michaela Falkner, NMD - Immune System

Babesia is a little different from Lyme (borrelia) and Bartonella in that it is not a bacteria, but a parasite that is more similar to malaria than bacteria. Babesia has been found in all 50 states and likes to target the red blood cells. Babesia infection is often in addition to lyme infection as well and we often need to treat both.

Symptoms

Symptoms vary from person to person but we tend to see more pulmonary involvement in Babesia.
Most common symptoms are:
- Shortness of breath with negative pulmonary tests, frequent sighing or air hunger, anxiety, night sweats and chills, flushing/hot flushes, the sensation of bugs crawling on your skin, pressure headaches on the top of your head.

Testing

Like all tick-borne infections, testing is difficult. You can get antibody testing at a general lab or Igenix. These tests are often not very sensitive and can come back falsely negative.
FISH testing: FISH testing is looking for unique RNA codes in Babesia. It has been the gold standard for testing Babesia and is available through Igenix.

Treatment

Treatment has more in common with treating malaria than Bartonella or Borrelia.
Prevention is the best cure! Here are some handy tips from Igenix on how to prevent Lyme disease. https://cdn.igenex.com/wp-content/uploads/2022-Lyme-Disease-Awareness-Month-Tips.pdf
Herbal Treatment: The favorite herbs to treat babesia are Artemisia (wormwood), just like malaria. Other herbs that are effective are Japanese Knotweed, Cryptoleptis, Chinese Skullcap. Japanese Knotweed, Cryptoleptis, and Chinese Skullcap are luckily also effective at Lyme and Bartonella as well!
Antibiotics: Antibiotics of choice are Bactrim, Atovaquone, and Azithromycin.
Ozone therapy: ozone kills bacteria, viruses, and fungi.
Treat other supportive body systems: address the thyroid, adrenal glands, vitamin levels, and multiple other organ systems to ensure your body can fight the Babesia and other co-infections.

As with the other co-infections and Lyme, I find it is easiest to assess which infection is causing the most issues symptomatically and start treatment focused on that microorganism, eventually expanding treatment to cover all co-infections as tolerated.

Dr. Falkner has attended ILADS (International Lyme and Associated Diseases Society) conferences as well as has years of experience treating Lyme both naturally and with antibiotics.

For more information – here are more Dr. Falkner articles:

Conference Pearl – Supplementing Testosterone in Men reduces Cardiovascular Risk and Helps control Blood Sugar

By Michaela Falkner, NMD - Men's Health

I recently attended the Advanced Applications in Medical Practice (AAMP)’s fall conference focusing on endocrinology. This was a 3-day, multi-doctor panel that taught all things endocrinology – the study of hormones. I especially was intrigued by the research showing low testosterone in men affects cardiovascular risk and blood sugar regulation.

Type 1 Diabetes

While I personally don’t have any type 1 diabetics currently in my practice, I gleaned quite a bit from the diabetes talk by Dr. Jodi Stanislaw, NMD. If you recall, type 1 diabetes is where the body starts to attack the pancreas via autoimmune antibodies, and you cannot make insulin to be able to utilize the blood sugar. This can be life threatening and the patient is insulin dependent. There were many nuanced and often overlooked helpful points about blood sugar that can be applied to pre and type 2 diabetes.

Prediabetes and Type 2 Diabetes

I do see quite a few patients with prediabetes and type 2 diabetes, where the body’s glucose/sugar use is dysfunctional and often controlled by diet or if needed, supplements and oral medications. Their body can still produce insulin, but sometimes the communication between insulin production and use breaks down.

Hormones and Blood Sugar Regulation – an Important Connection

While blood sugar and hormones (estrogen, progesterone, testosterone) are often not linked together, the Endocrine Society is now recognizing this relationship as more important in the management of diabetes than previously understood.

There have been numerous studies regarding the beneficial relationship testosterone has on blood sugar regulation and atherosclerosis (the buildup of plaques in the artery walls which can cause high blood pressure, heart attacks, and cardiovascular disease).

The Endocrine Society is now recommending measuring testosterone in all newly diagnosed diabetic men as testosterone has not been found to necessarily effect the blood sugars directly, but moreover the inflammation that accompanies high blood sugar.

Bottom line: adding testosterone replacement therapy to a diabetic’s regimen improves cardiovascular inflammation, decreases cardiovascular risk, and decreases obesity. I think this research is amazing and will begin measuring testosterone in my male prediabetic and diabetic patients to further decrease cardiovascular risk!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3167667/

Bartonella – a Lyme Look-a-Like

By Michaela Falkner, NMD - Immune System

Like Lyme disease, bartonella can also cause a host of symptoms that are migratory and spam multiple body systems. There are several species of the bacteria bartonella which can cause multiple diseases in patients, including Cat Scratch Fever (no, it wasn’t just a song in the 80s) and Trench Fever. Bartonellosis has been detected in 49 out of the 50 states. It often is referred to as a co-infection as these bacteria reside in many of the same ticks, mosquitos, spiders, etc as Lyme disease does.

Symptoms

Symptoms vary from person to person but tend to affect the gastrointestinal and neurological systems more significantly than Lyme and babesia.
Common symptoms:
- Light/touch/sound sensitivity, plantar fasciitis or pain on heel/sole of foot, anxiety, migratory neuropathy/pins and needles/tingling/burning, “stretch marks” that stay purple/pink and don’t run in the correct position, brain fog, sudden and unprovoked nausea.

Testing

Testing is difficult with Bartonella because this bacteria hides INSIDE cells. We often rely on antibodies to bartonella to diagnose it. You can get antibody testing either at a general lab or thru Igenix.
FISH testing: FISH testing is looking for the unique RNA code in Bartonella. This is more specific and sensitive than antibody testing alone. This is available through Igenix. https://igenex.com/disease/bartonella/
RED Labs* – PCR or DNA testing for Bartonella. This is also available through general labs like Quest or LabCorp.

*Correction from Lyme article – RED Labs also has a unique way of testing lyme/Borellia called phage testing. This test is on the forefront of Lyme detection and can determine if lyme disease is active or if your immune system has just seen this infection in the past.

Treatment

Prevention is the best cure! Here are some handy tips from Igenix on how to prevent Lyme disease. https://cdn.igenex.com/wp-content/uploads/2022-Lyme-Disease-Awareness-Month-Tips.pdf
Herbal Treatment – There are many herbal treatments for Bartonella, with considerable overlap with Lyme and other co-infections. Japanese Knotwood, Chinese Skullcap, Cryptolepis, and Black Walnut are some of the herbs that are specifically effective in treatment of Bartonella. Herbal formulations are nice in the treatment of tick borne illness because it is much easier to tailor the dose to the tolerance of the patient.
Antibiotics – Antibiotics of choice are rifampin, methylene blue, and ciprofloxacin.
Ozone therapy – ozone kills bacteria, viruses, and fungi.
Treat other supportive body systems: address the thyroid, adrenal glands, vitamin levels, and multiple other organ systems to ensure your body can fight the Lyme

Oftentimes Bartonella accompanies Lyme and other co-infections. I find it is easiest to assess, through history, which bacteria is causing the majority of issues and start with treatment focused on that specific microorganism and then, as tolerated, expand treatment to the other bacteria/organisms. Again, this doesn’t have to be a lifelong diagnosis, but one that can be treated and managed. Dr. Falkner has attended ILADS (International Lyme and Associated Diseases Society) conferences as well as has years of experience treating Lyme both naturally and with antibiotics. Please call for a free phone consult with her if you want to know if she could help in your case.

Lyme Disease

By Michaela Falkner, NMD - Immune System

Lyme disease is caused by the bacteria Borrelia Burgdorferi or Borrelia Miyamotoi (tick borne relapsing fever). This disease was first discovered in the 80s and is often categorized as acute disease vs chronic disease. Lyme disease has been documented in all 50 states, so even states with relatively low tick populations are not spared. Acute Lyme is fairly well recognized and treated in mainstream medicine, but there is contention over the existence of chronic Lyme disease and other tick-borne co-infections. This is because the symptoms are often migratory and span multiple body systems. Because of this lack of clear diagnostic tools and guidelines, it has been estimated that undiagnosed Lyme disease costs Americans $712 million to 1.3 billion dollars per year in treatment and medical visits (Aucott 2015). Lyme disease profoundly affects both patients and loved ones.

Symptoms

Symptoms vary depending on each person and how long the bacteria have been in the body. Most common symptoms are as follows:
- Swollen, painful joints; neuropathies; migraines; POTS and changes in heart rhythms and rate; sudden new onset anxiety; brain fog; fatigue; mood changes, GI symptoms.
- Many of the symptoms are often migratory in nature (if pain) or come and go with seemingly no reason.

Testing

Testing is notoriously difficult with Lyme because of its unique ability to change shape when exposed to antibiotics. CDC criteria is very exclusive and oftentimes does not recognize the changes in the immune system that Lyme can cause.
General labs:
- CD57 – this is a particular white blood cell that is “spent” fighting Lyme and other diseases. If low, likely an infection is causing symptoms.
- Western blot – Not very specific. Most often will only detect 84% of positive Lyme cases.
- Antibodies to Borrelia – also not super specific and Borrelia is particularly good at avoiding the immune system and not “following the rules” of the immune system.
Specialized labs:
- Igenix – We use Igenix laboratory as they are the gold standard of Lyme detection. Their testing is much more sensitive than the general labs. Average sensitivity is closer to 90-96%. This means that the test can catch up to 12% of Lyme cases missed by standard western blot testing. https://igenex.com/the-igenex-advantage/

Treatment

Prevention is the best cure! Here are some handy tips from Igenix on how to prevent Lyme disease. https://cdn.igenex.com/wp-content/uploads/2022-Lyme-Disease-Awareness-Month-Tips.pdf
Herbal treatment – There are many herbs including Japanese Knotweed and Cat’s Claw that are effective in treating Lyme. Herbal treatments are often easier to adjust the dosing to tolerance as well as easier to take long term.
Antibiotics – doxycycline is the antibiotic of choice for Lyme.
Ozone therapy – ozone kills bacteria, viruses, and fungi.
Treat other supportive body systems: address the thyroid, adrenal glands, vitamin levels, and multiple other organ systems to ensure your body can fight the Lyme.

Lyme disease does not have to be forever. Treatment can take a long time, but there are many examples of patients improving their quality of life when diagnosed and treated appropriately.

Dr. Falkner has attended ILADS (International Lyme and Associated Diseases Society) conferences as well as has years of experience treating Lyme both naturally and with antibiotics.

Is Autoimmunity Created in the Gut? Studies are Pointing to Yes…

By Michaela Falkner, NMD - Immune System

The field of microbiome research is exploding, from autism to autoimmune disease and even branching out into the new field of psychobiotics (probiotics for mood/mental health). Ultimately, we are finding we are much more than just what we eat; many of our health parameters and even our quality of mental health are tightly linked to the bacterial community that lives in our gut. The microbiome refers to the balance of good and bad bacteria populations that live in our large intestine. Many factors can change the microbiome including even how we were born! Other things that can influence the microbiome’s health is eating fermented foods, exercise, food and alcohol habits, smoking, stress, and use of certain medications and antibiotics. An altered microbiome has long been linked to abdominal pain, altered bowel movements, and IBS.

The truly interesting and new info is that we are finally linking the microbiome to autoimmune diseases and diseases that are not classically thought of as GI diseases. Autoimmune diseases are where the body no longer can differentiate between self and foreign invader and will attack particular tissues that have been misidentified as “not ourself”. Lupus, rheumatoid arthritis, antiphospholipid syndrome have all been identified as possibly being started by disruptions in our microbiome. What might be more exciting is a Canadian research group was recently given a sizeable grant to study the potential treatment of ALS (Aka Lou Gehrig’s disease) with a specific strain of probiotics! This could be ground-breaking! Researchers are also calling for more research in the treatment of autism spectrum disorders with probiotics as well! I linked a few of the studies and articles below.

Naturopathic medicine always has believed that much of health is created in the gut and the basis of treatment in my practice for autoimmune diseases specifically has always been to begin with digestion. It’s nice to see science following suit and what we intrinsically knew many years ago is being shown to be correct.

Test your Gut Microbiome with a Simple Stool Sample
https://pubmed.ncbi.nlm.nih.gov/29920643/
https://alsnewstoday.com/news-posts/2022/02/25/1-6-million-canada-grant-supports-trial-probiotic-slowing-als-progression/

Keys to Maximizing Exercise Recovery

By Michaela Falkner, NMD - Exercise

Many people include exercising more and joining a gym or fitness center in their New Years resolutions. However, after that first workout or two, the soreness kicks in and can make working through the soreness difficult. Here are some tips that help to alleviate muscle soreness, decrease inflammation, and keep you on the track to health.

Contrast Showers
- Many athletes swear by ice baths after a tough workout. There are increasing studies showing that muscles recover faster and performance increases when contrast baths are used. Contrast showers are easy to do at home. You run a hot shower and stand in it for about 5 minutes. Turn the water to cold and stay under it for 30 seconds. Repeat this 3 times. A study of rugby players showed that athletes performed better and reported being less sore the day after contrast baths versus 5-minute ice baths.
Castor oil
- Topical castor oil is amazingly anti-inflammatory and can be used for everything from detoxification, to hormone balancing, to aching joints and muscles. Just be careful, it stains!
Herbal formulations
- Some useful herbs are passionflower, Siberian ginseng, crampbark, and cordyceps. Call us to make an appointment for a personalized formulation!
Proper Nutrition: Protein, BCAAs
- Don’t forget to give your muscles the building blocks to repair and grow. A good protein powder and BCAAs (branched chain amino acids) are integral to fast recovery and muscle repair. Feeding your body is one of the most important things to do in helping to build muscle and alleviate soreness. Other amino acids that aid in increased blood flow, increased growth hormone secretion, and muscle building are: choline, glutamine, and arginine.
Mitochondrial Support
- The mitochondria are the powerhouses of the cell. Carnitine and acetyl L-carnitine have been shown to decrease inflammation and carnitine is one of the key components in energy synthesis of cells, including muscle cells. B-vitamins are also imperative to make those powerhouses run. Magnesium is also key to mitochondria as well as muscle soreness.
Hormone Optimization
- Make sure your testosterone and DHEA levels are optimal so you can grow your muscles and recover faster. Low estrogen can cause muscle achiness and joint pain. Also making sure your thyroid and adrenals are in tip top shape will also help to recover and get the most from your workout.
SLEEP!
- Sleeping at least 8 hours a night will not only help you wake rested and energetic for another gym session, but also helps to increase growth hormone. Growth hormone is secreted at night during deep, restful sleep and while doing fasted strenuous exercise.

Before starting any regimen, its best to talk with your doctor and discuss other options for faster recovery and a healthier you! I’d love to help you recover faster from work outs and keep your nervous and endocrine system healthy while you gain strength, endurance, and health! Make an appointment at 208-338-0405.

Long COVID Connection to Chronic Infections Including Epstein-Barr Virus (EBV) & Lyme

By Michaela Falkner, NMD - Immune System

Now that COVID 19 has been rocketing around the globe for over 18 months, we are starting to be able to study a new phenomenon of the virus: Long COVID aka Post-Acute COVID Syndrome (PACS). Long COVID is a constellation of symptoms that remain for more than 30 days after testing positive, oftentimes taking 4-5 months (or longer) to start to improve. These symptoms are commonly fatigue, brain fog, sleep difficulties, joint and muscle pains, sore throat, headache, fever, GI issues, and skin rashes. So far, PACS doesn’t appear to correspond to the severity of the COVID infection with even asymptomatic COVID patients diagnosed.

Reactivation of Other Infections – Epstein-Barr (EBV)

Scientists have begun to wonder if long covid isn’t unique, but actually reactivated EBV. Epstein-Barr virus (EBV) is the virus that causes mono and is estimated to have infected 95% of adults at least once in their life.

Epstein-Barr Virus has been long known to go dormant after initial infection and reactivate when the immune system is “distracted” with other stressors and illnesses. EBV has also been linked to Hashimoto’s thyroid disease, small intestine bacterial overgrowth, and even some cancers.

Symptoms of reactivated EBV are just as vague, and almost identical to, long COVID: fatigue, brain fog, sleep disturbances, joint and muscle pains, sore throat, headaches, fever, GI issues, and skin rashes.

Patients with EBV stay in ICU Longer

Various retrospective studies have shown that between 66-95% of COVID ICU patients (dependent on geographical location) tested positive for reactivated EBV as well with one French study showing that patients with reactivated EBV had an average 15-day ICU stay vs 8-day ICU stay without EBV co-infection.

COVID and Lyme

Symptoms of Long COVID and chronic Lyme can often overlap as well. The CDC reports a decrease in Lyme diagnoses; however, it may be artificially low due to telehealth appointments and missing tell-tale symptoms of Lyme such as the bullseye rash (though only 50% of patients get a rash), swelling of the joints, and heart rhythm abnormalities. There is concern that Lyme patients, since they are chronically inflamed, are at a higher risk of complications due to COVID as well as many Lyme patients also have reactivated EBV. The presence of the reactivated EBV and other immune system strain may translate into more Lyme patients developing Long COVID, though this has yet to be studied.

How Naturopathic Medicine Can Help

I have effectively helped patients with chronic infections such as EBV, Lyme, and even mold using natural and conventional therapies. Choices include antiviral, immune modulating, and anti-inflammatory herbs & medications, replacing various nutrients, and even using ozone therapies. Ozone historically is quite effective at treating viruses, and may have applications in long COVID as well, though this needs more study. Ultimately, recovering from chronic infections involves evaluating and balancing multiple body systems, including optimizing digestive, hormonal, and cellular health.

Resource: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233978/