Author: Michaela Falkner, NMD

Boise Natural Health Clinic now Carries Beyond Balance Product Line!

By - Miscellaneous

Boise Natural Health Clinic is now partnered with Beyond Balance Inc to provide gentle herbal formulations for our chronic complex patients. 

Chronic complex illness is complicated

As many of my patients know, chronic complex illness can not only be difficult to recognize and diagnose, but also difficult to treat. There are so many different factors that play into a body’s ability to tolerate various herbal, nutritional, and even pharmaceutical products. Oftentimes, patients’ bodies are very sensitive and what is well tolerated in one person (or even at one time in a single person’s life!) can’t be tolerated in another person (or time!). This is where Beyond Balance comes in.

We need products to use in sensitive patients

Beyond Balance https://beyondbalanceinc.com/ was created and formulated by an herbalist, Susan McCamish, and is used comprehensively throughout the US, Europe, Canada, and Australia. Her formulations are targeted at supporting the body’s abilities to detox and heal at a cellular level using herbs. These supplements are formulated to be used at very low doses and tend to be very well tolerated in even the most sensitive patients. I typically use Beyond Balance in my Lyme, mold, and co-infection treatment plans.

Successful case study of patient with severe allergic reactions

Over the years, I have used multiple of their formulations, but my most significant response was in a VERY sensitive patient who would have a sensation of a severe allergic reaction to multiple everyday odors/environments. We had tried multiple detox supportive supplements, which all caused the same reaction in her. We even tried using food as medicine and found she reacted to adding a tablespoon of cilantro to her diet! We decided to try Tox-Ease GL, which is a very gentle detox formulation by Beyond Balance. We started at 1 drop once a week and, as she could tolerate it, she increased her dose. I’m happy to report that now she can live her life relatively unbothered by her symptoms (they are almost completely gone!) and even engage in activities that would previously trigger her! She’s not even on the supplement anymore. These products are easy to take and effective!

If you are struggling with chronic complex illness, call for a free phone consultation with Dr. Falkner to see if she might be able to help. 

Methylene Blue – The Oldest New Med: for Energy, Chronic Infections, and More!

By - Miscellaneous

Methylene blue is one of the oldest synthesized medications to exist. It was originally made in 1876 for malaria. It was approved by the FDA for a condition called methemoglobinemia, which is a relatively rare condition. In simplest terms, methylene blue helps increase the oxygen carrying capacity of the red blood cells.

So, what can methylene blue be used for?

– We have found that not only is methylene blue great for saving lives and fighting malaria (its official uses), but it’s an amazing mitochondrial support that also has anti-inflammatory and antioxidant uses. Methylene blue has been in the news recently for these “anti-aging” actions. By boosting the mitochondria (remember in 8th grade biology- “mitochondria is the powerhouse of the cell” – it generates the energy currency our bodies run on), we increase energy production in the body.

– We also use methylene blue for neurological protection and health, including for concussions, dementia, depression, chronic fatigue, and long COVID neurological symptoms. Methylene blue is especially good for chronic fatigue due to its anti-inflammatory effects, its mitochondrial support (it enables us to skip steps in energy production!), and its ability to also boost mood.

– Lastly, we can combine methylene blue with other meds and supplements to better treat difficult infections like mold, babesia, bartonella, viruses (including potential for long COVID and EBV), and even pain.

We can give Methylene Blue both orally and IV. Unusually, methylene blue is well absorbed and crosses the blood brain barrier easily orally. However, side effects can include nausea (much better with lots of water), headaches, fast heart rate, and blue/green urine and/or saliva.

Methylene blue has a long history of use for various conditions safely. We can use this as another tool to enhance brain function, energy, mood, and fatigue!

Long COVID

By - Immune System


Covid is Here to Stay

It’s pretty clear that COVID is here to stay. It continues to not only infect new cases but continues to wreak havoc in the already infected longer than the traditional medical model previously considered possible. Long COVID is a poorly understood constellation of symptoms (both mental and physical) that persist for more than 2 months after infection of COVID that significantly impacts a person’s life and isn’t explained by an alternative diagnosis (Mikkelsen & Abramoff, 2023).

Long Covid Symptoms

The most common symptoms in long COVID are fatigue, difficulty breathing, joint pain, chest pain, and cough (Sudre & Et.al, 2020), but we are often seeing brain fog, anxiety, dizziness, and difficulty in regulating heart rate and blood pressure. Symptoms can also change day to day. We don’t know what causes long COVID and its unclear who is at most risk of developing long COVID due to conflicting reports. What we do know is 87% of patients hospitalized with COVID will still experience symptoms after 2 months (Carfi, Bernabei, & Landi, 2020), so this is not an uncommon issue. Meanwhile, most patients do start to see improvement in their symptoms in 4-9 months (Mikkelsen & Abramoff, 2023) even without intervention.

Why Do Some People Get It?

So, what is causing long COVID? We aren’t sure. There are a few ideas, but it boils down to the following themes: reactivation/reemergence of COVID or other viral illnesses like Epstein Barr virus (Gold, Okyay, Licht, & Hurley, 2021).  Other contributing factors are immune system dysregulation, energy metabolism defects, and imbalances of pro and anti-inflammatory processes.  

Treatment Options

Fortunately, as naturopathic physicians, we are very used to treating many of these proposed causes of chronic viral infections naturally. Data shows glutathione/NAC, antioxidants, quercetin, curcumin, magnesium all have potential to balance inflammation and treat spike protein related pathologies (Halma & Plothe, 2023). We can also use Ozone IVs and rectal insufflations to modulate inflammation and help the immune system to kill COVID viral particles (Cenci, Macchia, & ET.al, 2022). We can also use antiviral herbs like cat’s claw, lemon balm, and licorice that have evidence of very robust antiviral properties. We can use nutrients like acetyl l carnitine, alpha lipoic acid, vitamin C to help restore the energy metabolism defects.

Ultimately, treatment isn’t (and shouldn’t) be once size fits all.  Often we are supporting multiple body systems for overall improved health – helping the body to heal itself.   We customize our approach of testing and treatments to help address your long COVID symptoms and support your healing.

References

Carfi, A., Bernabei, R., & Landi, F. (2020, July 9). Persistent Symptoms in Patients After Acute COVID-19. Retrieved from JAMA Network: https://jamanetwork.com/journals/jama/fullarticle/2768351

Cenci, A., Macchia, I., & ET.al. (2022, April 21). Mechanisms of Action of Ozone Therapy in Emerging Viral Diseases: Immunomodulatory Effects and Therapeutic Advantages With Reference to SARS-CoV-2. Retrieved from National Library of Medicine: https://pubmed.ncbi.nlm.nih.gov/35531273/

Gold, J. E., Okyay, R. A., Licht, W. E., & Hurley, D. J. (2021, June 17). Investigation of Long COVID Prevalence and Its Relationship to Epstein-Barr Virus Reactivation. Retrieved from National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233978/

Halma, M. T., & Plothe, C. (2023, May 17). Strategies for the Management of Spike Protein-Related Pathology. Retrieved from National Library of Medicine: https://pubmed.ncbi.nlm.nih.gov/37317282/ Mikkelsen, M. E., & Abramoff, B. (2023, June 19). COVID-19: Evaluation and management of adults with persistent symptoms following acute illness (“Long COVID”). Retrieved from UpToDate: https://www.uptodate.com/contents/covid-19-evaluation-and-management-of-adults-with-persistent-symptoms-following-acute-illness-long-covid/print

Sudre, C. H., & Et.al. (2020, June 16). Symptom clusters in Covid19: A potential clinical prediction tool from the COVID Symptom study app. Retrieved from MedRxiv: https://www.medrxiv.org/content/10.1101/2020.06.12.20129056v1.full

Mitochondrial Damage and Chronic Illness

By - Miscellaneous

In late May, I attended the 13th Advanced Applications for Medical Practice (AAMP)’s conference on Mitochondrial Medicine: Healing in Chronic and Post Infectious Illness. It is a 3-day conference that is packed with amazing information that I’ve been attending for the last three years.

The Cell’s Mitochondria – damage creates long-term symptoms

As some of us remember from school biology, mitochondria are the powerhouse of the cell.  Inside them, complex processes occur to create ATP, which is the currency of energy for the body. These processes (anyone remember the Kreb’s cycle or Electron Transport Chain?) are very delicate and highly dependent on multiple nutrients to work correctly.

There is new information that chronic inflammation as well as chronic and acute infections (including Epstein Barr virus, COVID 19, etc), and even medications and toxins can damage our mitochondria and may contribute to post-infectious illness (such as Long Covid), chronic fatigue from other diseases like cancer, Lyme, and autoimmune disease, and other dysfunctions in the body.

So, when you treat the illness or source of inflammation, but still don’t feel better, you may need to address damaged mitochondria.  By giving more nutrients and also by removing obstacles to healing. 

Nutrients power energy production

The main nutrients needed to power mitochondrial production of energy include carnitine, alpha lipoic acid, multiple B vitamins, CoQ10, PQQ, selenium, zinc, and multiple other antioxidants. We also use phosphatidylcholine to help replace the delicate membrane of the mitochondria as well to allow better diffusion of nutrients in and energy out from both the cells and mitochondria. Here at Boise Natural Health Clinic, for broad spectrum mitochondrial support, we like MitoNRG, MitoCore, and BioPC Pro.

Are your Mitochondria Working?

We can indirectly test the function of mitochondria with a urine test called an Organic Acid Test (OAT). The OAT test is a nice 10,000 foot view of overall health. The test can give general information about the health of the mitochondria and Kreb’s cycle, gastrointestinal infections and health, indirect neurotransmitter measurements, vitamin levels, and detox abilities. I often use this test when I’m not sure where to start with a case or am suspicious of mitochondrial dysfunction, GI dysfunction, and nutrient deficiency. Contact us if you’d like to get an Organic Acid Test by Mosaic Diagnostics and get a glimpse of your mitochondrial health!

Spring Allergies – tools for symptoms and prevention

By - 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 - 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 - 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 - 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 - 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 - 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/